Clinical features of 30 children with protracted bacterial bronchitis by follow-up study / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the clinical features of protracted bacterial bronchitis (PBB)and provide clinical data for its diagnosis and treatment.Methods The clinical data of children with PBB who were admitted to the Respiratory Department of Children's Hospital of Chongqing Medical University from January 2012 to December 2015 were retrospectively collected,including the total information,clinical feature,auxiliary tests and treatment data.One year follow-ups were carried out to record cough relapse.Results In 30 patients with PBB,the ratio of boy and girl was 1812,the median age were 14.5 (7-49.5) months,and the median duration of cough was 9.7 (5.7-17.1) weeks.All children had chronic wet cough,in which 22/30 (73.3％)had wheezing reported by their parents,and 14/30 cases (46.7％) had wheezing observed by doctors.Chest X ray showed increased and thickened of lung texture in 9/30 cases (30.0％);chest CT showed uneven inflation in 8/28 cases (28.6％),and 2 patients had suspected bronchiectasis.Sinusitis and allergic rhinitis were seen in 16/30 cases (53.3％) who underwent nasal endoscopy.Bronchoscopy showed a chronic bronchitis accompanied with superior secretions in all patients,in which 11/30 cases (36.7％)showed a purulent bronchitis,5/30 cases(16.7％) had tracheobronchial stenosis,and 3/30 cases (10.0％) had tracheomalacia.The major pathogens identified by bronchial alveolar lavage fluid (BALF)were Streptococcus pneumoniae (12 cases),Haemophilus parainfluenzae (10 cases) and Moraxella catarrhalis (7 cases).All PBB patients had cough remission after (10.0 ± 2.5) days of intravenous antibiotics followed by oral antibiotics therapy.Two out of twenty-three cases (8.7％) had a recurrent PBB,and 1 patient developed into irreversible bronchiectasis by 1 year follow-up with the missing follow-up rate of 23.3 ％.Conclusions Children with PBB are typically younger (≤ 3 years) with prolonged wet cough and wheezing,and some cases are accompanied with sinusitis and allergic rhinitis.Bronchoscopy can detect chronic bronchitis with superior secretions,which is often be purulent with respiratory malformation in elderly children.An appropriate therapy with antibiotics is effective,but some patients may will experience recurrent PBB,which might even progress into bronchiectasis.