Persistent adenoviral infection and chronic obstructive bronchitis in children: Is there a link?

Chronic obstructive bronchitis with inadequate response to inhaled steroid and bronchodilator therapy is a rather rare disorder in children. Persisten ce of an adenoviral infection has been described as a possible cause of unr emitting airway obstruction. We studied a group of 11 children with the cli nical feature of chronic bronchial obstruction. A high-resolution computed tomography (HR-CT) scan was performed and typically showed hyperinflation a nd ground-glasslike opacities. All children underwent either bronchoscopic transbronchial or open lung biopsy. Biopsy specimens were stained with mono clonal antibodies detecting adenoviral antigen and analyzed by light-micros copy. Bronchoalveolar lavage (BAL) fluid was cultured for adenovirus, and a ntigen detection tests were performed. While some children had a history of proven adenoviral infection at the onset of their disease, in none of the cases could a persistence of adenovirus be shown. We conclude that adenovir al infection might act as a starter of chronic obstructive bronchitis in ch ildren, but that pathogenetic mechanisms other than persistent infection mu st be responsible for the chronicity of the disease. (C) 2001 Wiley-Liss, I nc.