Interstitial lung disease in children — clinical case

Case summary

This infant presents with the defining picture of children's interstitial lung disease in infancy: months of persistent tachypnoea that never settled despite treatment for presumed bronchiolitis, diffuse fine crackles, hypoxaemia unmasked by feeding, and failure to thrive. The essential insight is that chronic, diffuse respiratory trouble of this kind is not a run of infections but an abnormal interstitium, and she meets the chILD syndrome — respiratory symptoms, respiratory signs, hypoxaemia, and diffuse imaging change — once the common causes have been excluded. ^{[1] [2]}