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[Clinical features and therapy of persistent bacterial bronchitis in 31 children]
1Department 2 of Respiratory Diseases, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing 100045, China.
Insights
Persistent bacterial bronchitis (PBB) in young children presents with chronic wet cough and often includes fever and wheezing. Prompt antibiotic treatment, typically with amoxicillin-clavulanate, leads to complete recovery in most cases.
Area of Science:
- Pediatric Respiratory Medicine
- Infectious Diseases
- Clinical Microbiology
Background:
- Persistent bacterial bronchitis (PBB) is a common cause of chronic cough in young children.
- Accurate diagnosis and effective treatment are crucial for favorable outcomes.
Purpose of the Study:
- To investigate the clinical characteristics, diagnostic findings, and therapeutic outcomes of persistent bacterial bronchitis in children.
Main Methods:
- A retrospective review of 31 pediatric patients diagnosed with PBB between October 2010 and May 2014.
- Analysis of clinical symptoms, chest imaging (X-ray, HRCT), bronchoscopy findings, microbiological cultures, and treatment responses.
Main Results:
- The study included 31 patients (17 boys, 14 girls) aged 6 months to 3 years, with chronic wet cough (>4 weeks) as the primary symptom.
- High-resolution computed tomography (HRCT) frequently showed bronchial wall thickening and peri-bronchial infiltration.
- Streptococcus pneumoniae was the most common pathogen identified in respiratory secretions, and most patients recovered with amoxicillin-clavulanate or cephalosporins.
Conclusions:
- Persistent bacterial bronchitis typically affects children under three years old, presenting with chronic wet cough, fever, and wheezing.
- HRCT and respiratory secretion cultures are valuable diagnostic tools.
- Effective antibiotic therapy, particularly with amoxicillin-clavulanate or advanced cephalosporins, results in high recovery rates.
Objective:
To investigate the clinical features and therapy of persistent bacterial bronchitis (PBB).
Method:
A retrospective review of 31 patients with PBB from Octorber 2010 to May 2014 in Department 2 of Respiratory Diseases in Beijing Children's Hospital was undertaken.
Result:
(1) The patients (17 boys and 14 girls) were 6 months to 3 years old. The main complaint was chronic wet cough (>4 weeks); 13 cases had fever and 25 cases had wheezing. Rattle was heard on auscultation in all patients. (2) Chest X ray showed an increase in bronchovascular markings in all cases, accompanied by patchy infiltration in 6 cases. The high resolution computed tomography (HRCT) demonstrated bronchial wall thickening in 25 cases, associated with peri-bronchial patchy infiltration in 18 cases, with organized pneumonia in 7 cases ( atelectasis in 5 cases). Centrilobular nodules and ground-glass opacity were observed in the remaining 6 patients. (3) Purulent secretion was seen in endobronchial cavity by bronchoscopy. Streptococcus pneumoniae was isolated from sputum culture or bronchoalveolar lavage fluid culture in 16 patients. (4)Patients recovered completely after over 2 weeks'treatment with amoxicillin-clavulanate or the second and third generation cephalosporin (including enzyme inhibitors) in 28 cases, carbapenems, teicoplanin , linezolid in 1 case respectively.
Conclusion:
PBB often occurred in 3 years old or younger patients and had chronic wet cough for more than 4 weeks, fever and wheezing. HRCT may reveal bronchial wall thickening, respiratory secretions culture may reveal Streptococcus pneumoniae. Most of patients recovered completely after over 2 weeks'treatment with amoxicillin-clavulanate or the second or third generation cephalosporins (including enzyme inhibitors).
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