postinfectious bronchiolitis obliterans

Postinfectious bronchiolitis obliterans (PIBO) is an irreversible obstructive lung disease that develops following a severe lower respiratory tract infection in early childhood. The disease is characterized by subepithelial inflammation and fibrotic narrowing of the bronchioles, which leads to persistent airway obstruction. Diagnosis is primarily based on clinical history, imaging studies that reveal features such as mosaic perfusion and air trapping, and lung function tests that demonstrate reduced airflow. Although precise prevalence data is not available, this condition predominantly affects young children after an infection, and its severity varies considerably among affected individuals.

Individuals with PIBO typically present with signs of chronic airway obstruction following a lower respiratory tract infection. Clinical features often include decreased forced expiratory volume in one second, air trapping, and characteristic computed tomography findings such as mosaic perfusion and bronchiectasis. Because spirometry can be challenging in very young children, the diagnosis is usually based on a combination of clinical history and imaging results. Not all individuals experience all these features, and the severity of symptoms can vary widely.

Postinfectious bronchiolitis obliterans develops as a consequence of a severe respiratory infection in early childhood that triggers an inflammatory response, resulting in subepithelial inflammation and fibrotic narrowing of the small airways. There is no known genetic basis for this condition, and it is not considered to be inherited. Instead, environmental factors, particularly infections during early childhood, play a central role in its development. Ongoing research aims to better understand the complex interplay of factors that lead to the irreversible airway damage seen in PIBO.

Currently, management of postinfectious bronchiolitis obliterans focuses on supportive care and symptom management rather than curative treatments. A multidisciplinary approach, often involving pulmonologists and respiratory therapists, is used to optimize lung function and address complications related to chronic airway obstruction. Interventions may include measures to manage airflow limitation and improve overall respiratory status, with treatment plans tailored to the individual’s needs. Patients should discuss treatment options with their healthcare team to determine the most appropriate strategies for their specific situation.

The long-term outlook for individuals with postinfectious bronchiolitis obliterans varies widely; some maintain relatively stable respiratory function while others may experience progressive challenges. With current standards of care, many individuals are able to manage their symptoms and maintain a reasonable quality of life, although outcomes depend on the extent of lung damage and individual response to supportive measures. Severity and symptoms vary widely between individuals, and outcomes described in medical literature continue to evolve as standards of care improve. Families often find it helpful to connect with pulmonology specialists and respiratory therapy services to explore care options and support strategies.