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Asian-Oceanian Journal of Pediatrics and Child Health Volume Three December 2004 Number Two BRONCHIOLITIS OBLITERANS SECONDARY TO MEASLES INFECTION
A. Fadzil1 ,Asiah K 2, Zaleha AM3 , Norzila MZ2
Correspondence: Dr Norzila Mohamed Zainudin Respiratory Unit, Paediatric Department, Institute of Paediatrics, Hospital Kuala Lumpur 50586 Kuala Lumpur, Malaysia
ABSTRACT Introduction: Measles infection is known to cause severe lung injury which results in development of bronchiolitis obliterans. We present five cases of bronchiolitis obliterans caused by post-measles pneumonia referred to the Respiratory Unit of the Institute of Paediatrics, Hospital Kuala Lumpur. Method: This is a retrospective analysis of the data based on the clinical notes. The diagnosis of bronchiolitis obliterans was based on the clinical presentations and high resolution computed tomograms (HRCT) findings of individual patients. No lung biopsies were performed on these patients. The diagnosis of measles was confirmed by typical clinical presentations and positive measles IgM. Results : All the cases were admitted between November 2003 and April 2004 when there was an increased incidence of measles in the country. The age of the patients was between 5 months to 44 months. Three patients were males. One patient had failure to thrive, one had asthma, and one had asthma with allergic rhinitis. The clinical presentations were persistent respiratory symptoms and signs after the acute episode of measles. The main physical findings were tachypnoea, generalised coarse crepitations and wheeze. The x-ray findings were hyperinflated lung, perihilar opacities and atelectasis. The HRCT findings were mosaic perfusion pattern, scattered air trapping, hyperinflated lung, segmental atelectasis and lobar collapse. All patients responded to a course of tapering dose of oral steroids over a period of four to six weeks. Two patients were discharged with inhaled steroids, one patient with inhaled steroids and long-acting β2-agonist, one patient with inhaled steroid and anti-leukotrienes and one patient with inhaled steroid, long acting β2 agonist and anti-leukotrienes. The duration of oxygen requirement was between 10 to 62 days with a mean of 35.4 days. All patients were not immunised for measles.
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Latest Journal Volume Three December 2004 Number Two
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