Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital
Background: Postinfectious bronchiolitis obliterans (PIBO) is a chronic obstructive lung disease with scanty information in literature on etiology, clinical profile, treatment, and outcome. Objective: The objective of the study is to describe the clinical profile and course of children diagnosed wit...
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doaj-873c5aa0d7e44eabbffc8f6abd2f8ef12020-11-24T22:09:55ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2020-01-0137181210.4103/lungindia.lungindia_145_19Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospitalKrishna Mohan GullaKana Ram JatRakesh LodhaSushil K KabraBackground: Postinfectious bronchiolitis obliterans (PIBO) is a chronic obstructive lung disease with scanty information in literature on etiology, clinical profile, treatment, and outcome. Objective: The objective of the study is to describe the clinical profile and course of children diagnosed with PIBO. Methods: A chart review of children below 18 years of age diagnosed as PIBO over the past 9 years was carried out. Details of clinical profile, laboratory investigations, imaging, treatment received, and outcome were recorded. Results: Eight children (boys 4) with PIBO were identified. Median (interquartile range [IQR]) age at the first episode of acute severe bronchiolitis such as illness and diagnosis of PIBO was 15 (6, 23.5) and 30 (16.5, 60) months, respectively, indicating a delay in diagnosis. The most common symptoms were recurrent episodes of cough (100%), fast breathing (100%), wheezing (87.5%), and fever (62.5%). Median (IQR) number of hospitalizations and episodes of antibiotic use prior to diagnosis were 2.5 (2, 5.5) and 2 (2, 4), respectively. Three (37.5%) children received mechanical ventilation during previous hospitalizations. Chest computed tomography revealed mosaic attenuation in 8 (100%), ground-glass opacities in 2 (25%), and bronchial wall thickening in 2 (25%). After diagnosis, 7 received oral steroids, 7 received hydroxychloroquine, 5 received azithromycin, and 2 received azathioprine. The median (IQR) duration of follow-up (n = 6) was 6 (1.5, 9.5) months. Median (IQR) number of pulmonary exacerbations in follow-up was 2 (1, 5). Conclusion: PIBO is still an under-recognized entity with substantial delay in diagnosis and unnecessary use of antibiotics. Clinical course with imaging findings may help to diagnose and manage this entity.http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=1;spage=8;epage=12;aulast=Gullachildrenpostinfectious bronchiolitis obliteransmosaic attenuationsteroids |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Krishna Mohan Gulla Kana Ram Jat Rakesh Lodha Sushil K Kabra |
spellingShingle |
Krishna Mohan Gulla Kana Ram Jat Rakesh Lodha Sushil K Kabra Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital Lung India children postinfectious bronchiolitis obliterans mosaic attenuation steroids |
author_facet |
Krishna Mohan Gulla Kana Ram Jat Rakesh Lodha Sushil K Kabra |
author_sort |
Krishna Mohan Gulla |
title |
Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_short |
Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_full |
Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_fullStr |
Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_full_unstemmed |
Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_sort |
clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
publisher |
Wolters Kluwer Medknow Publications |
series |
Lung India |
issn |
0970-2113 0974-598X |
publishDate |
2020-01-01 |
description |
Background: Postinfectious bronchiolitis obliterans (PIBO) is a chronic obstructive lung disease with scanty information in literature on etiology, clinical profile, treatment, and outcome. Objective: The objective of the study is to describe the clinical profile and course of children diagnosed with PIBO. Methods: A chart review of children below 18 years of age diagnosed as PIBO over the past 9 years was carried out. Details of clinical profile, laboratory investigations, imaging, treatment received, and outcome were recorded. Results: Eight children (boys 4) with PIBO were identified. Median (interquartile range [IQR]) age at the first episode of acute severe bronchiolitis such as illness and diagnosis of PIBO was 15 (6, 23.5) and 30 (16.5, 60) months, respectively, indicating a delay in diagnosis. The most common symptoms were recurrent episodes of cough (100%), fast breathing (100%), wheezing (87.5%), and fever (62.5%). Median (IQR) number of hospitalizations and episodes of antibiotic use prior to diagnosis were 2.5 (2, 5.5) and 2 (2, 4), respectively. Three (37.5%) children received mechanical ventilation during previous hospitalizations. Chest computed tomography revealed mosaic attenuation in 8 (100%), ground-glass opacities in 2 (25%), and bronchial wall thickening in 2 (25%). After diagnosis, 7 received oral steroids, 7 received hydroxychloroquine, 5 received azithromycin, and 2 received azathioprine. The median (IQR) duration of follow-up (n = 6) was 6 (1.5, 9.5) months. Median (IQR) number of pulmonary exacerbations in follow-up was 2 (1, 5). Conclusion: PIBO is still an under-recognized entity with substantial delay in diagnosis and unnecessary use of antibiotics. Clinical course with imaging findings may help to diagnose and manage this entity. |
topic |
children postinfectious bronchiolitis obliterans mosaic attenuation steroids |
url |
http://www.lungindia.com/article.asp?issn=0970-2113;year=2020;volume=37;issue=1;spage=8;epage=12;aulast=Gulla |
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