Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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A case of bronchiolitis obliterans developed after adenovirus type 7 pneumonia

7형 아데노바이러스 폐렴 후 발생한 폐쇄 세기관지염 1례

  • Park, Hyo-Khan (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Lee, So-Yeon (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Kim, Young-Ho (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Oh, Phil-Soo (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Kim, Jae-Yoon (Department of Pediatrics, National Medical Center) ;
  • Jung, Yoon-Seok (Korea Center for Diseases Control and Prevention) ;
  • Kang, Chun (Korea Center for Diseases Control and Prevention) ;
  • Kim, Kwang-Nam (Department of Pediatrics, College of Medicine, Hallym University)
  • 박효간 (한림대학교 의과대학 소아과학교실) ;
  • 이소연 (한림대학교 의과대학 소아과학교실) ;
  • 김영호 (한림대학교 의과대학 소아과학교실) ;
  • 오필수 (한림대학교 의과대학 소아과학교실) ;
  • 김재윤 (국립의료원 소아과) ;
  • 정윤석 (질병관리본부) ;
  • 강춘 (질병관리본부) ;
  • 김광남 (한림대학교 의과대학 소아과학교실)
  • Published : 2007.05.30
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Abstract

Bronchiolitis obliterans is a clinical syndrome of chronic obstruction associated with inflammatory changes in the small airways. There are marked variations in the epidemiology of this disease. In childhood, bronchiolitis obliterans has been described as a result of a number of infections such as adenovirus, measles, Bordetella pertussis, Mycoplasma pneumoniae, and influenza A infection. Most common agents are adenovirus types 3, 7, and 21. Diagnosis of bronchiolitis obliterans can be made based on clinical findings, high resolution computed tomography (HRCT) and lung biopsy. In addition to diagnosis, treatment is not yet clearly established. The authors experienced a case of bronchiolitis obliterans developed in 3 year-old girl who suffered from type 7 adenoviral pneumonia. She had been hospitalized and treated for 15 days due to pneumonia. After discharge, productive cough was not improved and auscultation revealed wheezing. HRCT demonstrated multifocal mosaic patterns suggesting bronchiolitis obliterans. She was managed with inhaled steroid and bronchodilator, and her symptoms were improved. However, follow up HRCT showed no interval change.

폐쇄 세기관지염은 아데노바이러스, 인플루엔자, 파라인플루엔자, 홍역바이러스, 폐렴미코플라스마, 호흡기 세포융합바이러스 등에 의해서 생길 수 있다. 특히 3, 7, 21형 아데노바이러스의 경우에는 급성기의 심한 폐증상을 일으킬 뿐만 아니라 만성적인 합병을 남길 수 있다. 이에 7형 아데노바이러스에 의한 심한 폐렴 후, 만성적인 기침 및 호흡기 증상을 가진 환아를 HRCT를 통해 폐쇄 세기관지염으로 진단하였고, 이후 흡입 스테로이드와 흡입 기관지확장제를 통해 증상을 조절한 1례를 경험한 바 문헌 고찰과 함께 보고하는 바이다.

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