Figure - available from: European Journal of Inflammation
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(a) High-resolution CT scan of the chest shows bilateral mosaic ground-glass patterns with air trapping in a 27-month-old child with BO after allogeneic hematopoietic stem cell transplantation. (b) High-resolution CT scan of the chest shows bilateral mosaic ground-glass patterns with air trapping in a 19-month-old child with post-infectious BO. (c) High-resolution CT scan of the chest shows pulmonary atelectasis on both lungs in a 20-month-old child with post-infectious BO. (d) High-resolution CT scan of the chest shows bilateral mosaic ground-glass patterns with air trapping and bronchiectasis at the level of the lower lobes in a 20-month-old child with post-infectious BO.
Source publication
Bronchiolitis obliterans (BO) is in general a rare and life-threatening form of non-reversible obstructive lung disease in which the bronchioles are compressed and narrowed by fibrosis and/or inflammation. The purpose of this study was to evaluate the clinical features of BO in pediatric patients and explore its risk factors. The medical records of...
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Citations
... In adults, bronchiectasis and pneumatoceles are most frequently caused by pathogens such as S. aureus and Pseudomonas aeruginosa (Daltro et al., 2011;Pizzutto et al., 2017). M. pneumoniae infection, often referred to as communityacquired pneumonia, can lead to bronchiolitis obliterans, characterized by inflammation and fibrosis of bronchioles, culminating in respiratory distress (Huang et al., 2017;Zheng et al., 2022). ...
Infectious diseases have consistently served as pivotal influences on numerous civilizations, inducing morbidity, mortality, and consequently redirecting the course of history. Their impact extends far beyond the acute phase, characterized by the majority of symptom presentations, to a multitude of adverse events and sequelae that follow viral, parasitic, fungal, or bacterial infections. In this context, myriad sequelae related to various infectious diseases have been identified, spanning short to long-term durations. Although these sequelae are known to affect thousands of individuals individually, a comprehensive evaluation of all potential long-term effects of infectious diseases has yet to be undertaken. We present a comprehensive literature review delineating the primary sequelae attributable to major infectious diseases, categorized by systems, symptoms, and duration. This compilation serves as a crucial resource, illuminating the long-term ramifications of infectious diseases for healthcare professionals worldwide. Moreover, this review highlights the substantial burden that these sequelae impose on global health and economies, a facet often overshadowed by the predominant focus on the acute phase. Patients are frequently discharged following the resolution of the acute phase, with minimal long-term follow-up to comprehend and address potential sequelae. This emphasizes the pressing need for sustained vigilance, thorough patient monitoring, strategic health management, and rigorous research to understand and mitigate the lasting economic and health impacts of infectious diseases more fully.
Background and Objective
Bronchiolitis obliterans (BO) is a rare but serious condition. The natural history and outcomes remain poorly understood. In this clinical review, we aimed to describe the clinical characteristics and outcomes of children diagnosed with BO in Hong Kong (HK).
Methods
This was a retrospective study of pediatric patients with BO under the care of six respiratory units in HK from January 1996 to December 2015. Information was retrieved from medical records.
Results
Fifty‐six patients were included with a male predominance (67.9%). The median age at diagnosis was 1.98 years (interquartile range [IQR]: 0.84–4.99 years). Postinfectious BO (PIBO) was the commonest cause (64.3%) followed by posthematopoietic stem‐cell transplant (21.4%). Adenovirus (63.2%) was the commonest causative pathogen among PIBO. The median follow‐up duration was 9.7 years (IQR: 2.9–14.3 years). Twenty‐five patients (44.6%) could achieve symptom‐free recovery at the time of follow‐up. Five (8.9%) and three (5.4%) were oxygen or ventilator dependent, respectively. There were two deaths, both had posttransplant BO. Patients who developed BO after transplant had significantly worse lung function than those with PIBO. There were no risk factors significantly associated with worse clinical outcomes (oxygen/ventilator dependence or death) by logistic regression. Among patients with PIBO, coinfection at presentation was significantly associated with persistent symptoms at follow‐up (p = .028).
Conclusions
The most common cause of childhood BO in HK is postinfectious and coinfection at presentation was associated with persistent symptoms at follow‐up. Further studies are needed to better elucidate disease progression, treatment options and long term outcomes.
