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Are airways structural abnormalities more frequent in children with recurrent lower respiratory tract infections?

Mikel Santiago-Burruchaga1, Rafael Zalacain-Jorge2, Carlos Vazquez-Cordero1

  • 1Paediatric Pulmonology Unit, Paediatric Department, Spain.

Respiratory Medicine
|April 9, 2014
PubMed

Insights

Children with recurrent lower airway infections often show airway malacia and increased respiratory secretions. These findings correlate with higher rates of positive bronchoalveolar lavage cultures, particularly for specific bacteria.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Clinical Microbiology

Background:

  • Recurrent lower airway infections (RLAI) in children can significantly impact respiratory health.
  • Bronchoscopy is a key diagnostic tool for evaluating airway abnormalities.

Purpose of the Study:

  • To compare bronchoscopic findings in children with RLAI versus controls.
  • To identify associations between airway malacia, secretions, and microbial findings in RLAI.

Main Methods:

  • Retrospective case-control study of children undergoing fiberoptic bronchoscopy (FB).
  • Reviewed clinical records, FB findings, and bronchoalveolar lavage (BAL) results.
  • Compared 62 children with RLAI to 29 control children.

Main Results:

  • Airway malacia (52% vs 13%) and profuse secretions (55% vs 20%) were significantly higher in RLAI cases.
  • Tracheobronchomegaly and endobronchial obstruction were noted in RLAI cases.
  • Profuse secretions in RLAI cases correlated with airway malacia and positive BAL cultures (45.5% vs 13.3%).

Conclusions:

  • Tracheo- and/or bronchomalacia are common in children with RLAI, occurring significantly more often than in controls.
  • RLAI is associated with increased respiratory secretions and a higher prevalence of positive BAL cultures.
  • Non-typable Haemophilus influenzae and Streptococcus pneumoniae were frequently isolated in RLAI cases.
Abstract

Keywords:
BronchitisBronchoalveolar lavageRecurrent lower respiratory airways infectionsTracheobronchomalacia

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