Etiology and Outcome of Diffuse Acute Infectious Bronchiolitis in Adults.
Ann Am Thorac Soc. 2015 Nov 2;
Authors: Ryu K, Takayanagi N, Ishiguro T, Kanauchi T, Kawate E, Kagiyama N, Sugita Y
RATIONALE: The etiology and outcome of diffuse acute infectious bronchiolitis (DAIB) in adults is not well known.
OBJECTIVES: To retrospectively review adult patients with diffuse acute infectious bronchiolitis without pneumonia, document the etiologies and outcomes, and assess the relation between diffuse acute infectious bronchiolitis and post-infectious bronchiolitis obliterans.
METHODS: We retrospectively analyzed medical records of 1664 patients with lower respiratory tract infections admitted to our institution in Saitama, Japan. Diffuse acute infectious bronchiolitis was diagnosed when patients developed acute feverish lower respiratory tract infection and chest computed tomography demonstrated mainly multiple centrilobular nodules in four or more lobes. Pneumonia was diagnosed when patients developed acute feverish lower respiratory tract infection and chest computed tomography demonstrated consolidation and/or ground-glass opacities with or without centrilobular nodules.
MEASUREMENTS AND MAIN RESULTS: Of the 1664 patients, 20 (1.2%) and 1644 (98.8%) patients were diagnosed as having diffuse acute infectious bronchiolitis and pneumonia, respectively. Of the 20 patients with diffuse acute infectious bronchiolitis, the etiology was determined in 16 (80%): 13 (65.0%) had a single pathogen and 3 (15.0%) had two pathogens. Detected organisms included Mycoplasma pneumoniae in 8 (40.0%) patients, influenza virus in 2 (10.0%), influenza virus and Streptococcus pneumoniae in 2 (10.0%), Haemophilus influenzae in 3 (15.0%), and respiratory syncytial virus and rhinovirus in 1 (5.0%) patient. All patients improved and none developed post-infectious bronchiolitis obliterans.
CONCLUSIONS: The three most common etiologies of diffuse acute infectious bronchiolitis in the studied adults were M. pneumoniae, influenza virus, and H. influenzae. None of the patients with diffuse acute infectious bronchiolitis developed post-infectious bronchiolitis obliterans.
PMID: 26524622 [PubMed - as supplied by publisher]