FIGURE 99.9 Idiopathic interstitial pneumonia An 18-year-old boy with chronic granulomatous disease, after bone marrow transplant, with insidious onset of shortness of breath The chest film shows bilateral interstitial disease in the lower lung field more on left side Management involves ongoing supportive care for any underlying etiology, in addition to treatment of the acute reason for exacerbation, such as viral infection or bacterial pneumonia Systemic corticosteroids may be part of the regimen if significant inflammation is suspected based on underlying condition Children with significant respiratory distress and/or hypoxemia may require hospitalization Suggested Readings and References Acute Respiratory Failure Friedman ML, Nitu ME Acute respiratory failure in children Pediatr Ann 2018;47(7):e268–e273 Gregoretti C, Pelosi P, Chidini G, et al Non-invasive ventilation in pediatric intensive care Minerva Pediatr 2010;62(5):437–458