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Etiology and Outcome of Diffuse Acute Infectious Bronchiolitis in Adults.
Ann Am Thorac Soc 2015; 12(12):1781-7AA

Abstract

RATIONALE

The etiology and outcome of diffuse acute infectious bronchiolitis (DAIB) in adults is not well known.

OBJECTIVES

To retrospectively review adult patients with DAIB without pneumonia, document the etiologies and outcomes, and assess the relation between DAIB and postinfectious bronchiolitis obliterans.

METHODS

We retrospectively analyzed medical records of 1,664 patients with lower respiratory tract infections admitted to our institution in Saitama, Japan. DAIB 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 1,664 patients, 20 (1.2%) and 1,644 (98.8%) patients were diagnosed as having DAIB and pneumonia, respectively. Of the 20 patients with DAIB, 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 eight (40.0%) patients, influenza virus in two (10.0%), influenza virus and Streptococcus pneumoniae in two (10.0%), Haemophilus influenzae in three (15.0%), and respiratory syncytial virus and rhinovirus in one (5.0%) patient. All patients improved and none developed postinfectious bronchiolitis obliterans.

CONCLUSIONS

The three most common etiologies of DAIB in the studied adults were M. pneumoniae, influenza virus, and H. influenzae. None of the patients with DAIB developed postinfectious bronchiolitis obliterans.

Authors+Show Affiliations

1 Department of Respiratory Medicine and.1 Department of Respiratory Medicine and.1 Department of Respiratory Medicine and.2 Department of Radiology, Saitama Cardiovascular and Respiratory Center, Saitama, Japan.1 Department of Respiratory Medicine and.1 Department of Respiratory Medicine and.1 Department of Respiratory Medicine and.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26524622

Citation

Ryu, Kai, et al. "Etiology and Outcome of Diffuse Acute Infectious Bronchiolitis in Adults." Annals of the American Thoracic Society, vol. 12, no. 12, 2015, pp. 1781-7.
Ryu K, Takayanagi N, Ishiguro T, et al. Etiology and Outcome of Diffuse Acute Infectious Bronchiolitis in Adults. Ann Am Thorac Soc. 2015;12(12):1781-7.
Ryu, K., Takayanagi, N., Ishiguro, T., Kanauchi, T., Kawate, E., Kagiyama, N., & Sugita, Y. (2015). Etiology and Outcome of Diffuse Acute Infectious Bronchiolitis in Adults. Annals of the American Thoracic Society, 12(12), pp. 1781-7. doi:10.1513/AnnalsATS.201507-473OC.
Ryu K, et al. Etiology and Outcome of Diffuse Acute Infectious Bronchiolitis in Adults. Ann Am Thorac Soc. 2015;12(12):1781-7. PubMed PMID: 26524622.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Etiology and Outcome of Diffuse Acute Infectious Bronchiolitis in Adults. AU - Ryu,Kai, AU - Takayanagi,Noboru, AU - Ishiguro,Takashi, AU - Kanauchi,Tetsu, AU - Kawate,Eriko, AU - Kagiyama,Naho, AU - Sugita,Yutaka, PY - 2015/11/3/entrez PY - 2015/11/3/pubmed PY - 2016/9/22/medline KW - adult KW - bronchiolitis KW - etiology KW - outcome KW - postinfectious bronchiolitis obliterans SP - 1781 EP - 7 JF - Annals of the American Thoracic Society JO - Ann Am Thorac Soc VL - 12 IS - 12 N2 - RATIONALE: The etiology and outcome of diffuse acute infectious bronchiolitis (DAIB) in adults is not well known. OBJECTIVES: To retrospectively review adult patients with DAIB without pneumonia, document the etiologies and outcomes, and assess the relation between DAIB and postinfectious bronchiolitis obliterans. METHODS: We retrospectively analyzed medical records of 1,664 patients with lower respiratory tract infections admitted to our institution in Saitama, Japan. DAIB 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 1,664 patients, 20 (1.2%) and 1,644 (98.8%) patients were diagnosed as having DAIB and pneumonia, respectively. Of the 20 patients with DAIB, 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 eight (40.0%) patients, influenza virus in two (10.0%), influenza virus and Streptococcus pneumoniae in two (10.0%), Haemophilus influenzae in three (15.0%), and respiratory syncytial virus and rhinovirus in one (5.0%) patient. All patients improved and none developed postinfectious bronchiolitis obliterans. CONCLUSIONS: The three most common etiologies of DAIB in the studied adults were M. pneumoniae, influenza virus, and H. influenzae. None of the patients with DAIB developed postinfectious bronchiolitis obliterans. SN - 2325-6621 UR - https://www.unboundmedicine.com/medline/citation/26524622/Etiology_and_Outcome_of_Diffuse_Acute_Infectious_Bronchiolitis_in_Adults_ L2 - http://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201507-473OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -