POSTINFECTIOUS BRONCHIOLITIS OBLITERANS - CLINICAL, RADIOLOGICAL AND PULMONARY-FUNCTION SEQUELAE

Background. There are few data on clinical, chest radiograph (CXR) or pulmonary function sequelae in children with post-infectious bronchiol itis obliterans (BO) (pulmonary crepitations, abnormalities on CXR, CT , nuclear medicine scans, or bronchography, with a history of past pul monary infection and in the absence of other underlying pathology). Ob jective. To analyse the methodology of diagnosis, long-term clinical i maging and pulmonary function sequelae of post-infectious BO in childr en. Materials and methods. Imaging (CXRs, CT and nuclear lung scans) a nd clinical histories of 19 children were analysed. Results. Clinical follow-up (mean 6.8 years), revealed a high incidence of continuing pr oblems (asthma and bronchiectasis). Fixed airway obstruction was the m ost common pulmonary function sequela. The sequelae on follow-up (mean 5.8 years) CXR were classified into five patterns which are illustrat ed: 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. Conclu sion. Long-term observations in children with post-infectious BO shoul d be undertaken to detect bronchiectasis and obstructive airway diseas e, Sequelae evident on CXR, other than those previously described, can be found. Bronchography and/or lung biopsy are not usually required f or the diagnosis of post-infectious BO.