[Bronchitis obliterans in children: report of two cases and literature review]

Abstract

Objective: 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.

Method: The clinical manifestations, characteristic imaging of two cases with bronchitis obliterans were summarized.

Result: 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.

Conclusion: 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.