Abstract
BackgroundBronchitis obliterans is a severe and extremely rare complication of respiratory tract infections in children and is characterized by massive atelectasis and collapse of the affected lung. Of the rare cases reported in the literature all surviving children underwent surgical resection of the collapsed lung.Case presentationWe report an infant with bronchitis obliterans that was treated conservatively. 5 years after the initial event, partial lung re-expansion was documented.ConclusionThis case therefore supports a conservative treatment whenever possible with pneumonectomy only as a last treatment option.
Highlights
BackgroundIn children bronchiolitis obliterans occurs most commonly secondary to infection [1]
Bronchitis obliterans is a severe and extremely rare complication of respiratory tract infections in children and is characterized by massive atelectasis and collapse of the affected lung
Of the rare cases reported in the literature all surviving children underwent surgical resection of the collapsed lung
Summary
In children bronchiolitis obliterans occurs most commonly secondary to infection [1]. Massive lung collapse occurred with partial spontaneous re-expansion 5 years later To our knowledge, this is the first case report documenting such an evolution. Chest X-ray revealed bilateral pulmonary infiltrates and the child was treated with intravenous antibiotics Ten days later he was referred to the university hospital because of persistent cough, increasing respiratory distress and atelectasis of the right lower and middle lobes on chest X-ray. A right lower lobe biopsy showed collapsed lung with normal histology and a slightly thickened visceral pleura and interlobular septae. The right lower lobe remains collapsed with part of the left lung herniated into the right hemithorax This partial re-expansion 5 years after the insult is associated with minute improvement in spirometric values: FVC 74% predicted and FEV1 62% predicted). No formal exercise testing was performed exercise capacity is very good since the patient was second in his school athletic competition run
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