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A pediatric disease to keep in mind: diagnostic tools and management of bronchiectasis in pediatric age

Marcella Gallucci1, Emanuela di Palmo1, Luca Bertelli1

  • 1Pediatric Unit, Department of Medical and Surgical Sciences, S. Orsola - Malpighi Hospital, University of Bologna, Via Massarenti 11, 40138, Bologna, Italy.

Italian Journal of Pediatrics
|December 30, 2017
PubMed

Insights

Pediatric bronchiectasis, a complex lung disease, often presents with chronic cough. Early diagnosis via HRCT is key, but some lesions may resolve, necessitating careful monitoring with techniques like MRI.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Medical Imaging in Pediatrics

Background:

  • Bronchiectasis in children is a diverse condition causing significant illness.
  • Common causes include pneumonia, recurrent infections, immune deficiencies, congenital defects, aspiration, and mucociliary disorders.
  • Chronic wet cough is the predominant symptom.

Purpose of the Study:

  • To review the diagnosis and management of pediatric bronchiectasis.
  • To highlight the role of imaging techniques like HRCT and MRI.
  • To discuss current treatment strategies and potential new therapies.

Main Methods:

  • Literature review of pediatric bronchiectasis.
  • Discussion of diagnostic modalities including High-Resolution Computed Tomography (HRCT) and Magnetic Resonance Imaging (MRI).
  • Analysis of current management approaches and emerging treatments.

Main Results:

  • HRCT improves early diagnosis but findings can be transient.
  • MRI offers a radiation-free alternative for assessment and follow-up.
  • Management requires a multidisciplinary team, with antibiotics and airway clearance techniques (ACT) as primary treatments.

Conclusions:

  • Pediatric bronchiectasis requires cautious diagnosis, considering the potential for lesion resolution.
  • MRI is a promising tool for monitoring lung abnormalities in non-Cystic Fibrosis lung disease.
  • Azithromycin presents a potential new strategy for preventing exacerbations due to its anti-inflammatory and antimicrobial properties.

Keywords:
Airway clearance techniquesAntibioticsAzithromycinChildren bronchiectasis; chronic wet coughHRCTMRI

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