Wang Jing, Yang Yan, Zhao Shun-ying
Department of Traditional Chinese Medicine, Beijing Children Hospital, Capital Medical University, Beijing 100045, China.
Zhonghua Er Ke Za Zhi. 2010 Oct;48(10):764-6.
Bronchitis obliterans is a severe and extremely rare complication of respiratory tract infections in children and is characterized by massive atelectasis and collapse of the affected lung.
The clinical manifestations, characteristic imaging of two cases with bronchitis obliterans were summarized.
These two cases complained of cough and episodes of wheezing with exercise. Chest auscultation revealed bronchial breath sounds on the right side. High-resolution computed tomography (HRCT) scan showed atelectasis of the right lung and dilated central airways. Mycoplasma complement fixation antibody (CF-Ab) titer was 1:320. The diagnosis of bronchitis obliterans was made according to the current diagnostic criteria. They were treated with low-dose erythromycin [5 mg/(kg × d)], ultrasonically nebulized Pulmicort inhalation, and regular bronchoscopic lavage. Follow-up of the two cases showed that case one had a partial lung re-expansion after six months, but case two had no significant improvement.
In the process of diagnosis of atelectasis, bronchitis obliterans should be noticed. A conservative treatment is effective in certain cases, but pneumonectomy or lobectomy should only be considered as the last option.
闭塞性细支气管炎是儿童呼吸道感染的一种严重且极为罕见的并发症，其特征为患侧肺出现大片肺不张和萎陷。
总结两例闭塞性细支气管炎患儿的临床表现及特征性影像学表现。
这两例患儿均有咳嗽及运动性喘息发作。胸部听诊右侧可闻及支气管呼吸音。高分辨率计算机断层扫描（HRCT）显示右肺肺不张及中央气道扩张。支原体补体结合抗体（CF-Ab）滴度为1:320。根据现行诊断标准确诊为闭塞性细支气管炎。给予低剂量红霉素[5毫克/（千克×天）]、普米克超声雾化吸入及定期支气管镜灌洗治疗。两例患儿随访结果显示，病例一在6个月后部分肺复张，但病例二无明显改善。
在诊断肺不张过程中，应注意闭塞性细支气管炎。保守治疗在某些病例中有效，但肺切除术或肺叶切除术仅应作为最后的选择。
