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Protracted bacterial bronchitis

Jorrit J V de Vries, Anne B Chang, Julie M Marchant
BACKGROUND: Endobronchial suppuration is present in children with protracted bacterial bronchitis (PBB), bronchiectasis, and cystic fibrosis (CF). However, no studies have directly compared bronchoscopy and bronchoalveolar lavage (BAL) findings across these conditions within a single center using the same techniques and with shared community pathogens. AIM: To determine; (i) the bronchoscopic findings and BAL microbiology and cellularity among children with these conditions and; (ii) the relationship between bacterial pathogens, airway cellularity and aberrant macroscopic bronchoscopic findings...
February 6, 2018: Pediatric Pulmonology
Paola Di Filippo, Alessandra Scaparrotta, Marianna Immacolata Petrosino, Marina Attanasi, Sabrina Di Pillo, Francesco Chiarelli, Angelika Mohn
Chronic cough in childhood is associated with a high morbidity and decreased quality of life. Protracted bacterial bronchitis (PBB) seems to be the second most common cause of chronic cough in children under 6 years of age. Its main clinical feature is represented by wet cough that worsens when changing posture and improves after the introduction of antibiotics. Currently, the mainstay of PBB treatment is a 2-week therapy with a high dose of antibiotics, such as co-amoxiclav, to eradicate the infection and restore epithelial integrity...
January 2018: Annals of Thoracic Medicine
Alice C-H Chen, Yang Xi, Melanie Carroll, Helen L Petsky, Samantha J Gardiner, Susan J Pizzutto, Stephanie T Yerkovich, Katherine J Baines, Peter G Gibson, Sandra Hodge, Ian B Masters, Helen M Buntain, Anne B Chang, John W Upham
Protracted bacterial bronchitis (PBB) in young children is a common cause of prolonged wet cough and may be a precursor to bronchiectasis in some children. Although PBB and bronchiectasis are both characterised by neutrophilic airway inflammation and a prominent interleukin (IL)-1β signature, the contribution of the IL-1β pathway to host defence is not clear. This study aimed to compare systemic immune responses against common pathogens in children with PBB, bronchiectasis and control children and to determine the importance of the IL-1β pathway...
October 2017: ERJ Open Research
Charlie Michaudet, John Malaty
Although chronic cough in adults (cough lasting longer than eight weeks) can be caused by many etiologies, four conditions account for most cases: upper airway cough syndrome, gastroesophageal reflux disease/laryngopharyngeal reflux disease, asthma, and nonasthmatic eosinophilic bronchitis. Patients should be evaluated clinically (with spirometry, if indicated), and empiric treatment should be initiated. Other potential causes include angiotensin-converting enzyme inhibitor use, environmental triggers, tobacco use, chronic obstructive pulmonary disease, and obstructive sleep apnea...
November 1, 2017: American Family Physician
Kim M Hare, Amanda J Leach, Heidi C Smith-Vaughan, Anne B Chang, Keith Grimwood
Streptococcus pneumoniae (pneumococcus) is the main cause of bacterial pneumonia worldwide and has been studied extensively in this context. However, its role in chronic endobronchial infections and accompanying lower airway neutrophilic infiltration has received little attention. Severe and recurrent pneumonia are risk factors for chronic suppurative lung disease (CSLD) and bronchiectasis; the latter causes considerable morbidity and, in some populations, premature death in children and adults. Protracted bacterial bronchitis (PBB) is another chronic endobronchial infection associated with substantial morbidity...
December 2017: Pediatric Pulmonology
Ahmad Kantar, Anne B Chang, Mike D Shields, Julie M Marchant, Keith Grimwood, Jonathan Grigg, Kostas N Priftis, Renato Cutrera, Fabio Midulla, Paul L P Brand, Mark L Everard
This European Respiratory Society statement provides a comprehensive overview on protracted bacterial bronchitis (PBB) in children. A task force of experts, consisting of clinicians from Europe and Australia who manage children with PBB determined the overall scope of this statement through consensus. Systematic reviews addressing key questions were undertaken, diagrams in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement constructed and findings of relevant studies summarised...
August 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Knut Øymar, Ingvild Bruun Mikalsen, Suzanne Crowley
No abstract text is available yet for this article.
August 22, 2017: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
Kerry-Ann F O'Grady, Benjamin J Drescher, Vikas Goyal, Natalie Phillips, Jason Acworth, Julie M Marchant, Anne B Chang
OBJECTIVE: Data on the aetiology of persistent cough at the transitional stage from subacute to chronic cough (>4 weeks duration) are scarce. We aimed to (1) identify the prevalence of chronic cough following acute respiratory illness (ARI) and (2) determine the diagnostic outcomes of children with chronic cough. DESIGN: Prospective cohort study. SETTING: A paediatric emergency department (ED) in Brisbane, Australia. PATIENTS: Children aged <15 years presenting with an ARI with cough...
November 2017: Archives of Disease in Childhood
Ahmad Kantar
Chronic cough in children is increasingly defined as a cough that lasts more than four weeks. It is recognized as a different entity than cough in adults. As a result, the diagnostic approach and management of chronic cough in children are no longer extrapolated from adult guidelines. These differences are attributed to the various characteristics of the respiratory tract, immunological system and nervous system in children. Specific paediatric guidelines and algorithms for chronic cough are now widely applied...
April 2017: Journal of Thoracic Disease
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
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