Post-infectious bronchiolitis obliterans in children: pathogenesis, treatment strategies, and future directions.

PURPOSE OF REVIEW: To provide a comprehensive and updated overview of post-infectious bronchiolitis obliterans (PIBO) in children, focusing on pathogenesis, diagnostic approaches, and current management strategies, while highlighting emerging mechanistic insights and future therapeutic directions.

RECENT FINDINGS: Recent studies emphasize neutrophilic inflammation, inflammasome activation (e.g., interleukin-18, caspase-1), and genetic susceptibility as key contributors to disease development and progression.

SUMMARY: PIBO is a heterogeneous and often underrecognized chronic lung disease requiring a structured diagnostic approach based on clinical, functional, and radiologic criteria. Management remains largely empirical and supportive, with limited evidence for disease-modifying therapies. Improved understanding of disease mechanisms may enable the development of targeted, phenotype-directed interventions in the future.