Bronchiolitis Obliterans after Adenovirus Type 7 Pneumonia

Kim, Chang Keun; Chung, Churl Young; Kim, Jung Suk; Lee, Hoan Jong; Piedra, Pedro A

Abstract

PURPOSE
The purpose of this study was to document bronchiolitis obliterans, the long term pulmonary sequelae of adenovirus type 7 pneumonia, using High Resolution CT(HRCT) and to identify risk factors that increase the likelihood of developing bronchiolitis obliterans.
METHODS
Thirty-nine children were admitted to the Inje University, Sanggye Paik Hospital in the early summer of 1996 with clinical adenoviral pnemonia. Type 7 adenovirus was isolated from 11 children. All eleven were reassessed clinically and performed HRCT in 1997, one year (12.1+/-1.9 mo) after the adenovirus type 7 pnemonia.
RESULTS
Seven (64%) had HRCT findings of BO(BO group) including mosaic perfusion, attenuation of pulmonary vessel and bronchiectasis, Four(36%) had a normal HRCT finding(Non-BO group). The mean age of the children on admission was lower in BO group(15.3+/-7.1 mo) than Non-BO group(35.3+/-14.2 mo) (P<0.05). The mean duration of fever was longer in BO group(14.4+/-2.8 days) than Non-BO group(6.3+/-2.5 days)(P<0.01). The mean duration of initial hospital admission was longer in BO group(28.0+/-10.8 days) than Non-BO group (9.8+/-3.6 days)(P<0.01). But the sex ratio between the two groups was not statistically significant. Four of the seven BO group subjects had bronchial asthma, and three of the four patients had persistent wheezing .
CONCLUSIONS
Adenovirus type 7 pneumonia is closely associated with bronchiolitis obliterans, the important long term pulmonary sequelae. The risk factors which increase the possibility of developing bronchiolitis obliterans are: the young age of the child, the long fever duration , and the long admission duration.