Aanhoudende tachypneu bij een zuigeling: mogelijk interstitiële pneumonitis

- In three male infants aged 3, 4.5 and 11 months with tachypnea and feeding problems, the initial supplementary examination revealed no possible cause. The tissue obtained by open lung biopsy showed interstitial pneumonia/pneumonitis. The two youngest patients were treated with hydrochloroquine and prednisone; the youngest died at the age of 18 months. Both the infant who was maintained on hydrochloroquine and the one who did not receive treatment showed a normal respiratory frequency and growth during the following years. Tachypnea is less easily recognised in infants than in older patients. It may be the only early symptom of interstitial pneumonitis. A normal chest X-ray cannot exclude an incipient interstitial pneumonitis as the cause of the tachypnea. A high-resolution CT-scan of the lung parenchyma is necessary in order to detect the disease at an early stage. Histological examination of an open lung biopsy specimen is essential for the specific diagnosis, therapy and prognosis.