Post Infection Constrictive Bronchiolitis in an Infant after SARSCoV- 2

Abstract

Bronchiolitis obliterans (BO) is characterized by being a chronic obstructive respiratory disease with irreversible histological changes and an unusual presentation in the pediatric population, for which reason it is underdiagnosed, however, in broncho-obstructive episodes of atypical or severe evolution, it should be considered as a diagnosis. Obliterative bronchiolitis is considered a chronic inflammatory disease of the bronchioles that can present in two histopathological ways, either by peribronchiolar involvement from the epithelium towards the lumen in a concentric (constrictive) way or by the occupation of the bronchiole lumen due to proliferation of endoluminal tissue (proliferative). The diagnosis is made according to clinical criteria and radiological criteria (chest CT), a score greater than 7 predicts with high precision the diagnosis of obliterative bronchiolitis. Since it is a chronic inflammatory disease mediated by the immune response, treatment is aimed at suppressing the inflammatory response to avoid lung damage due to irreversible changes, however, once the disease is established, treatment will be symptomatic, supportive, and follow-up of lung function. Next, the 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 post-infectious constrictive bronchiolitis were evidenced in its clinical evolution.