Post-infectious bronchiolitis obliterans: clinical, radiological and pulmonary function sequelae

Pediatr Radiol. 1998 Jan;28(1):23-9. doi: 10.1007/s002470050286.

Abstract

Background. There are few data on clinical, chest radiograph (CXR) or pulmonary function sequelae in children with post-infectious bronchiolitis obliterans (BO) (pulmonary crepitations, abnormalities on CXR, CT, nuclear medicine scans, or bronchography, with a history of past pulmonary infection and in the absence of other underlying pathology). Objective. To analyse the methodology of diagnosis, long-term clinical imaging and pulmonary function sequelae of post-infectious BO in children. Materials and methods. Imaging (CXRs, CT and nuclear lung scans) and clinical histories of 19 children were analysed. Results. Clinical follow-up (mean 6.8 years), revealed a high incidence of continuing problems (asthma and bronchiectasis). Fixed airway obstruction was the most common pulmonary function sequela. The sequelae on follow-up (mean 5.8 years) CXR were classified into five patterns which are illustrated: unilateral hyperlucency of an enlarged lung/part of lung; complete collapse of the affected lobe; unilateral hyperlucency of a small or normal-sized lung; bilateral hyperlucent lungs and a mixed pattern of persistent collapse, hyperlucency and peribronchial thickening. Conclusion. Long-term observations in children with post-infectious BO should be undertaken to detect bronchiectasis and obstructive airway disease. Sequelae evident on CXR, other than those previously described, can be found. Bronchography and/or lung biopsy are not usually required for the diagnosis of post-infectious BO.

MeSH terms

  • Bronchiolitis Obliterans / diagnosis*
  • Bronchiolitis Obliterans / etiology
  • Bronchiolitis Obliterans / physiopathology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infections / complications*
  • Lung / diagnostic imaging
  • Lung / physiopathology*
  • Lung Diseases / complications*
  • Male
  • Radiography, Thoracic
  • Radionuclide Imaging
  • Respiratory Function Tests
  • Tomography, X-Ray Computed