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Protracted bacterial bronchitis

Gregory J Redding, Edward R Carter
The most common clinical suppurative lung conditions in children are empyema, lung abscess, and bronchiectasis, and to a less often necrotizing pneumonia. Until recently, bronchiectasis was the most common form of persistent suppurative lung disease in children. Protracted bacterial bronchitis is a newly described chronic suppurative condition in children, which is less persistent but more common than bronchiectasis (1). In addition, the term "chronic suppurative lung disease" has been used recently to describe the clinical features of bronchiectasis when the radiographic features needed to make a diagnosis of bronchiectasis are absent...
2017: Frontiers in Pediatrics
Anne B Chang, John J Oppenheimer, Miles M Weinberger, Bruce K Rubin, Cameron C Grant, Kelly Weir, Richard S Irwin
BACKGROUND: Wet or productive cough is common in children with chronic cough. We formulated recommendations based on systematic reviews related to the management of chronic wet cough in children (aged ≤ 14 years) based on two key questions: (1) how effective are antibiotics in improving the resolution of cough? If so, what antibiotic should be used and for how long? and (2) when should children be referred for further investigations? METHODS: We used the CHEST expert cough panel's protocol for systematic reviews and the American College of Chest Physicians (CHEST) methodologic guidelines and GRADE framework (the Grading of Recommendations Assessment, Development and Evaluation)...
April 2017: Chest
Kim M Hare, Heidi C Smith-Vaughan, Anne B Chang, Susan Pizzutto, Helen L Petsky, Gabrielle B McCallum, Amanda J Leach
BACKGROUND: Chronic endobronchial infections in children are responsible for a high disease burden. Streptococcus pneumoniae is frequently isolated; however, few publications have described serotypes associated with non-invasive lower airway infection. METHODS: Paired nasopharyngeal (NP) swabs and bronchoalveolar lavage (BAL) fluids were collected from children undergoing bronchoscopy for chronic cough. NP swabs were also collected from asymptomatic children in otitis media surveillance studies (controls)...
February 1, 2017: Vaccine
Semiha Bahçeci, Sait Karaman, Hikmet Tekin Nacaroğlu, Selçuk Yazıcı, Saniye Girit, Şule Ünsal-Karkıner, Demet Can
Non-cystic fibrosis bronchiectasis again becomes a major health problem due to inappropriate antibiotic use and increasing frequency of protracted bacterial bronchitis. The aim was to determine the changes in etiology of bronchiectasis. Patients who admitted to Behçet Uz Children Hospital between 2005 and 2015 (n=110) were retrospectively examined. The etiology of bronchiectasis was detected as; primary ciliary dyskinesia 26.4%, protracted bacterial bronchitis 22.8%, primary immune deficiency 11.8%, bronchiolitis obliterans 8...
2016: Turkish Journal of Pediatrics
Danielle F Wurzel, Julie M Marchant, Stephanie T Yerkovich, John W Upham, Helen L Petsky, Heidi Smith-Vaughan, Brent Masters, Helen Buntain, Anne B Chang
BACKGROUND: Protracted bacterial bronchitis (PBB) and bronchiectasis are distinct diagnostic entities that share common clinical and laboratory features. It is postulated, but remains unproved, that PBB precedes a diagnosis of bronchiectasis in a subgroup of children. In a cohort of children with PBB, our objectives were to (1) determine the medium-term risk of bronchiectasis and (2) identify risk factors for bronchiectasis and recurrent episodes of PBB. METHODS: One hundred sixty-one children with PBB and 25 control subjects were prospectively recruited to this cohort study...
November 2016: Chest
Sandra Hodge, John W Upham, Susan Pizzutto, Helen L Petsky, Stephanie Yerkovich, Katherine J Baines, Peter Gibson, Jodie L Simpson, Helen Buntain, Alice C H Chen, Greg Hodge, Anne B Chang
BACKGROUND: Children with recurrent protracted bacterial bronchitis (PBB) and bronchiectasis share common features, and PBB is likely a forerunner to bronchiectasis. Both diseases are associated with neutrophilic inflammation and frequent isolation of potentially pathogenic microorganisms, including nontypeable Haemophilus influenzae (NTHi), from the lower airway. Defective alveolar macrophage phagocytosis of apoptotic bronchial epithelial cells (efferocytosis), as found in other chronic lung diseases, may also contribute to tissue damage and neutrophil persistence...
February 2016: Chest
Anne B Chang, John W Upham, I Brent Masters, Gregory R Redding, Peter G Gibson, Julie M Marchant, Keith Grimwood
Cough is the single most common reason for primary care physician visits and, when chronic, a frequent indication for specialist referrals. In children, a chronic cough (>4 weeks) is associated with increased morbidity and reduced quality of life. One common cause of childhood chronic cough is protracted bacterial bronchitis (PBB), especially in children aged <6 years. PBB is characterized by a chronic wet or productive cough without signs of an alternative cause and responds to 2 weeks of appropriate antibiotics, such as amoxicillin-clavulanate...
March 2016: Pediatric Pulmonology
Ahmad Kantar
Despite the high prevalence of cough in children, the topic has been poorly researched. Although pediatricians recognize that chronic cough in children is different from that in adults, this difference seems less recognizable to other health professionals. During childhood, the respiratory tract and nervous system undergo a series of anatomical and physiological maturation processes that influence the cough reflex. Additionally, immunological responses undergo developmental and memorial processes that make infection and congenital abnormalities the overwhelming cause of cough in children...
February 2016: Lung
Ahmet Hakan Gedik, Erkan Cakir, Emel Torun, Aysegul Dogan Demir, Mehmet Kucukkoc, Ufuk Erenberk, Selcuk Uzuner, Mustafa Nursoy, Emin Ozkaya, Fadlullah Aksoy, Selim Gokce, Kayhan Bahali
BACKGROUND: This study aims to evaluate the children with chronic cough and to analyze their etiological factors according to the age groups. METHOD: Five hundred sixty-three children with chronic cough were included. The last diagnosis were established and were also emphasized according to the age groups. RESULTS: The mean age was 5.4 ± 3.8 years (2-months-17-years) and 52 % of them were male. The most common final diagnosis from all the participants were: asthma (24...
2015: Italian Journal of Pediatrics
Yuqing Wang, Chuangli Hao, FanFan Chi, Xingmei Yu, Huiquan Sun, Li Huang, Meijuan Wang, Wei Ji, Yongdong Yan, Hong Zhu, Xuejun Shao
Protracted bacterial bronchitis (PBB) is the common cause of chronic cough in children worldwide, but its etiology has not been fully recognized in China. We retrospectively investigated a total of 66 hospitalized infants under the age of three years with chronic wet cough enrolled in the Affiliated Children's Hospital of Soochow University from October 2010 to March 2014. All patients underwent bronchoscopy and broncho-alveolar lavage (BAL) samples were processed for microbiological and cytological analysis...
2015: Scientific Reports
Aneela Bidiwala, Leonard R Krilov, Melodi Pirzada, Sameer J Patel
Pro: Children with chronic cough present a diagnostic challenge. Protracted bacterial bronchitis (PBB) is a chronic, persistent bacterial infection of conducting airways defined by the presence of cough for longer than 4 weeks that resolves with antimicrobial therapy and without an alternative diagnosis. The diagnosis is made by the findings of increased bronchial secretions and edema of the lower airways on flexible bronchoscopy and positive cultures on bronchoalveolar lavage. It is speculated that an initial respiratory insult such as viral infection disrupts normal surface morphology and ciliary function, which leads to chronic self-perpetuating inflammation with the formation of bacterial biofilms, leading to PBB...
August 2015: Pediatric Annals
Ann-Katrin Rother, Nicolaus Schwerk, Folke Brinkmann, Frank Klawonn, Werner Lechner, Lorenz Grigull
BACKGROUND: Clinical symptoms in children with pulmonary diseases are frequently non-specific. Rare diseases such as primary ciliary dyskinesia (PCD), cystic fibrosis (CF) or protracted bacterial bronchitis (PBB) can be easily missed at the general practitioner (GP). OBJECTIVE: To develop and test a questionnaire-based and data mining-supported tool providing diagnostic support for selected pulmonary diseases. METHODS: First, interviews with parents of affected children were conducted and analysed...
2015: PloS One
Stephen Oo, Peter Le Souëf
BACKGROUND: Wheezing is a common presentation in young children. Diagnosis and treatment of these children can be challenging, as arriving at a final diagnosis often requires a process of elimination. OBJECTIVE: This article aims to provide an algorithm for managing a young child with wheeze in the primary care setting. We will aim to address key questions of some controversy that relate to this algorithm: 1. Does the child actually have wheeze – how accurate is the parents' description? 2...
June 2015: Australian Family Physician
Matthew J Martin, Tim W Harrison
A chronic 'productive' or 'wet' cough is a common presenting complaint for patients attending the adult respiratory clinic. Most reviews and guidelines suggest that the causes of a productive cough are the same as those of a non-productive cough and as such the same diagnostic pathway should be followed. We suggest a different diagnostic approach for patients with a productive cough, focussing on the conditions that are the most likely causes of this problem. This review is intended to briefly summarise the epidemiology, clinical features, pathophysiology and treatment of a number of conditions which are often associated with chronic productive cough to aid decision making when encountering a patient with this often distressing symptom...
September 2015: Respiratory Medicine
Siba P Paul, Swathi Sanapala, Jayesh M Bhatt
Chronic moist cough in children can be associated with serious pathologies. Protracted bacterial bronchitis remains a clinical diagnosis causing persistent moist cough, disturbed sleep, exercise intolerance and significant levels of morbidity. Management involves minimal investigations and prolonged courses of antibiotics.
July 2015: British Journal of Hospital Medicine
Lilly M Verhagen, Ronald de Groot
Community-acquired pneumonia is a potentially life-threatening disease affecting children worldwide. Recurrent pneumonia episodes can lead to the development of chronic respiratory morbidity. Chronic wet cough, a common pediatric complaint, is defined as a wet cough indicating excessive airway mucus that lasts for a minimum of 4 weeks. Most children with a chronic wet cough do not suffer from underlying debilitating pulmonary disorders. Rather, chronic wet cough is generally associated with neutrophilic airway inflammation and bacterial infections of the conducting airways...
June 2015: Journal of Infection
G Benoist, E Bidat
A persistent cough lasting more than 4-8weeks should lead to a diagnostic workup. A detailed history and a full clinical examination, with a chest X-ray, are essential for initial assessment. Most reported causes of chronic cough in children are post-nasal drip syndrome, cough variant asthma (a spirometry with test of bronchodilator responsiveness should be attempted in children old enough to perform the manoeuvres). GERD is often suspected but a causal relationship is difficult to establish. Protracted bacterial bronchitis, post-infectious cough (B...
April 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Ravi Narang, Kelly Bakewell, Jane Peach, Sadie Clayton, Martin Samuels, John Alexander, Warren Lenney, Francis J Gilchrist
OBJECTIVES: Flexible bronchoscopy with bronchoalveolar lavage (FB-BAL) is increasingly used for the microbiological confirmation of protracted bacterial bronchitis (PBB) in children with a chronic wet cough. At our centre, when performing FB-BAL for microbiological diagnosis we sample 6 lobes (including lingula) as this is known to increase the rate of culture positive procedures in children with cystic fibrosis. We investigated if this is also the case in children with PBB. METHODS: We undertook a retrospective case note review of 50 children investigated for suspected PBB between May 2011 and November 2013...
2014: PloS One
Iulia Ioan, Mathias Poussel, Laurianne Coutier, Jana Plevkova, Ivan Poliacek, Donald C Bolser, Paul W Davenport, Jocelyne Derelle, Jan Hanacek, Milos Tatar, François Marchal, Cyril Schweitzer, Giovanni Fontana, Silvia Varechova
The cough reflex is modulated throughout growth and development. Cough-but not expiration reflex-appears to be absent at birth, but increases with maturation. Thus, acute cough is the most frequent respiratory symptom during the first few years of life. Later on, the pubertal development seems to play a significant role in changing of the cough threshold during childhood and adolescence resulting in sex-related differences in cough reflex sensitivity in adulthood. Asthma is the major cause of chronic cough in children...
2014: Frontiers in Physiology
Katherine J Baines, John W Upham, Stephanie T Yerkovich, Anne B Chang, Julie M Marchant, Melanie Carroll, Jodie L Simpson, Peter G Gibson
BACKGROUND: Protracted bacterial bronchitis (PBB) is a common and treatable cause of chronic wet cough in children in which the mechanisms are not understood. This study investigates the IL-1 pathway and a neutrophil gene expression signature in PBB. METHODS: BAL was collected from children in an experimental cohort (n = 21, PBB; n = 33, control subjects), and a second validation cohort (n = 36, PBB; n = 11, control subjects). IL-1β, IL-1 receptor antagonist (IL-1RA), and α-defensins 1-3 were assayed by enzyme-linked immunosorbent assay, western blot, and quantitative real-time polymerase chain reaction, together with selected IL-1 pathway members and neutrophil-related molecules...
October 2014: Chest
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