Clinical profile and course of children with postinfectious bronchiolitis obliterans (PIBO)from a tertiary care hospital in Nepal

<bold>Background:</bold> Post-infectious bronchiolitis obliterans(PIBO) is a chronic disease in childhood with limited information. <bold>Objective:</bold> To describe the clinical presentation, treatment and outcome of children diagnosed with PIBO. <bold>Method:</bold> Retrospective study that included data on clinical profile, imaging finding, treatment received, and outcome of children with diagnosed PIBO. PIBO was diagnosed in children who had not recovered completely from acute bronchiolitis-like illness in 6 weeks following with the evidence of small airway disease in high-resolution computerised tomography of the chest as suggested by mosaic perfusion with air trapping. <bold>Results:</bold> 12 children(10 males) diagnosed with PIBO were included in the study. Median(IQR)age at the first presentation and first diagnosis were 7(3,112) and 15(6,118) respectively. The most common presentation was persistent wheezing (100%) followed by fast breathing (80%) and persistent oxygen requirement (33%). Chest computed tomography revealed mosaic attenuation in 12 cases and bronchial wall thickening in 2 cases. Three patients received pulse methylprednisolone, 12 received oral prednisolone and hydroxychloroquine and 10 received azithromycin. Three out of three patients (100%) on home oxygen therapy were off oxygen by 6 weeks of treatment. Median (IQR) of pulmonary exacerbation during follow-up was 2(1,3). <bold>Conclusion:</bold> The diagnosis of PIBO is delayed keeping children at risk of unnecessary antibiotics and admission. Information on clinical courses can help in early diagnosis and management.