Abstract
BackgroundThis study aimed to describe the clinical characteristics, radiological features and outcomes of 42 children with post-infectious bronchiolitis obliterans (PIBO).MethodsForty-two children diagnosed with PIBO were prospectively studied at the First Hospital of Jilin University in northern China between January, 2008 and January, 2013. Their clinical characteristics, lung high resolution computed tomography (HRCT) findings and pulmonary function tests were reported.ResultsIn children with PIBO, adenovirus was the most common etiologic agent (21/42), followed by Mycoplasma pneumoniae (M. pneumoniae). All of the patients presented with repeated wheezing and tachypnea. In addition, 22 patients required intensive management, while six patients required home oxygen therapy. HRCT findings were consistent with the PIBO diagnosis in all of the patients. Pulmonary function testing was useful in evaluating therapeutic responses. Systemic steroids combined with azithromycin were effective for PIBO treatment.ConclusionsSevere adenovirus bronchiolitis and M. pneumoniae infections have a higher risk of development for PIBO. HRCT and pulmonary function testing are useful in the diagnosis of PIBO. The degree of airway obstruction did not differ significantly between adenovirus and M. pneumoniae. A combination of steroids and azithromycin offers some benefit in treating these patients.
Highlights
This study aimed to describe the clinical characteristics, radiological features and outcomes of 42 children with post-infectious bronchiolitis obliterans (PIBO)
A total of 42 children diagnosed with Post-infectious bronchiolitis obliterans (PIBO) based on high resolution computed tomography (HRCT) and clinical features were identified
Our study showed that airway obstruction was present in all of the patients diagnosed with PIBO, and the degree of obstruction was not different among the three groups
Summary
This study aimed to describe the clinical characteristics, radiological features and outcomes of 42 children with post-infectious bronchiolitis obliterans (PIBO). Bronchiolitis obliterans (BO) was first reported and named in 1901 as small airway injury-related chronic inflammation airflow obstruction syndrome [1]. Post-infectious bronchiolitis obliterans (PIBO) is especially common in children [2,4]. One study found that 47.4% of children hospitalized with adenovirus pneumonia developed BO during 5 years of follow-up [5]. There is no effective treatment and it has a poor prognosis [6,7]. We prospectively analyzed the clinical characteristics, radiological features and outcome of 42 children with PIBO in order to describe key aspects of the diagnosis and treatment of PIBO
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