Resumo

GARCIAA, María Isabel et al. Post Infection Constrictive Bronchiolitis in an Infant after SARS-CoV-2. Univ. Med. [online]. 2022, vol.63, n.1, pp.148-154.  Epub 30-Dez-2021. ISSN 0041-9095.  https://doi.org/10.11144/javeriana.umed63-1.bron.

Bronchiolitis obliterans is a chronic and irreversible pulmonary disease that leads to obstruction and obliteration of the small airways and that can present by peribronchiolar involvement, from the epithelium towards the lumen in a concentric (constrictive), or by occupation of the lumen of the bronchiole, given by proliferation of the endoluminal tissue (proliferative). The lesion at the level of the small airway can occur after lung or bone marrow transplantation, infections, inhalation of toxic substances, connective tissue diseases or secondary to drugs. In the pediatric population, the constrictive form secondary to severe respiratory tract infections, and known as post-infectious bronchiolitis obliterans (PIBO), is the most common and its clinical presentation can be highly variable from mild to severe airway obstruction that does not respond to treatment with bronchodilators, in addition to hypoxemia, cough and tachypnea. Diagnosis is difficult given the previous need for a lung biopsy, the current absence of biomarkers, and since its pathophysiology is not clearly understood. The CT as well as a clinical score predict with high precision the diagnosis of obliterative bronchiolitis. Treatment is aimed at suppressing the inflammatory response to prevent lung damage. We report a case of a 2-month-old infant with a history of respiratory infection due to SARS-CoV-2 (COVID-19) in his neonatal period is presented, in whom radiological and clinical changes compatible with PIBO were evidenced.

Palavras-chave : constrictive bronchiolitis; coronavirus infection; infant; immune response; inflammation; respiratory tract disease.

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