Clinical analysis of bronchiectasis in Taiwanese children

The clinical features and etiology of bronchiectasis have rarely been described in non-Caucasian populations, of whom the prevalence of cystic fibrosis is low. In this report, we studied the clinical features of bronchiectasis in Taiwanese children.

Using a retrospective chart review, 29 cases of bronchiectasis were diagnosed from 1991 through 2001. For each case, the diagnosis was confirmed using high-resolution computed tomography. Medical records were analyzed for demographic data, clinical presentation, spirometric data, and microbial isolation. Radiographic findings were reviewed, and possible causes of bronchiectasis were also identified.

There were 17 girls and 12 boys enrolled. Persistent cough, daily sputum production, and hemoptysis were common presenting symptoms. Crackles and wheezing were the most frequent findings during the physical examination. Previous lower airway infection, asthma, and primary immunodeficiency were the most common, but 31.0% of the cases had unknown causes. Dependent lobes were involved more frequently. Simultaneous sinusitis was noted in 70.6% of the cases. Spirometry showed mild airway obstruction in most of the cases. Most specimens (52.2%) from lower airway secretions yielded bacterial pathogens, most commonly Pseudomonas aeruginosa, Haemophilus influenzae and Streptococcus pneumoniae.

Continuing post-infectious inflammatory changes remains the most important cause of bronchiectasis in a non-Caucasian pediatric population in Northern Taiwan in the 1990s. More than two thirds of these patients had underlying predisposing factors including asthma, immunodeficiency, and swallowing dysfunction. Chronic productive purulent respiratory secretions and persistent crackles should raise the possibility of bronchiectasis in children even in Taiwan where the incidence of cystic fibrosis is low.