Instituto Nacional de Salud del Niño-Breña.
Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola. Lima, Perú.
Bol Med Hosp Infant Mex. 2023;80(5):312-319. doi: 10.24875/BMHIM.23000045.
Postinfectious bronchiolitis obliterans is a rare lung disease; there are limited reports in South America.
We report 10 patients with this disease diagnosed at the Instituto Nacional de Salud del Niño-Breña (Lima-Peru). The median age at diagnosis was 19 months and all patients had a history of severe acute respiratory infection. The most frequent symptoms were cough, respiratory distress, wheezing, and hypoxemia. The mosaic attenuation pattern was the most frequent on the tomography. All the patients had positive serology for adenovirus. The treatment received was methylprednisolone pulses, azithromycin, hydroxychloroquine, and inhaled corticosteroids. No patient died during the follow-up.
In previously healthy children with a history of severe acute respiratory infection and persistent bronchial obstructive symptoms, the diagnosis of postinfectious bronchiolitis obliterans should be considered. This is the first report in Peru with a therapeutic regimen adapted to our institution.
感染后细支气管炎性闭塞是一种罕见的肺部疾病,在南美洲的报道有限。
我们报告了在利马-秘鲁的国家儿童健康研究所(Instituto Nacional de Salud del Niño-Breña)诊断出的 10 名患有这种疾病的患者。诊断时的中位年龄为 19 个月,所有患者均有严重急性呼吸道感染史。最常见的症状是咳嗽、呼吸窘迫、喘息和低氧血症。体层摄影术上最常见的是马赛克衰减模式。所有患者的腺病毒血清学均为阳性。接受的治疗是甲基强的松龙脉冲、阿奇霉素、羟氯喹和吸入皮质类固醇。在随访期间,没有患者死亡。
对于有严重急性呼吸道感染史和持续支气管阻塞症状的既往健康儿童,应考虑诊断感染后细支气管炎性闭塞。这是秘鲁的首例报告,采用了适合我们机构的治疗方案。