Pediatric bronchiectasis: An orphan disease ending in pneumonectomy: A case report

Bronchiectasis is chronic infectious and inflammatory disease that results in irreversible thickening and dilatation of bronchi, and significant lung function decline in children. Prompt early diagnosis and multidisciplinary intervention is crucial to control recurrent exacerbation and preserve lung function.

We present a case of pediatric bronchiectasis in a 10-year-old female who presented with a complaint of intermittent wet cough of 5 weeks' duration associated with low grade intermittent fever, shortness of breath, easy fatigability and loss of appetite. Left pneumonectomy was done through left posterolateral thoracotomy and she was discharged home in good condition.

Recurrent lower tract air way infections are the most common causes of pediatric bronchiectasis followed by primary immune deficiency, primary ciliary dyskinesia, foreign body aspiration and airway structural abnormalities. It is crucial to equip health care professionals with adequate knowledge about the disease as most pediatric patients may not have productive cough like adults leading to misdiagnosis or significant delay in diagnosis. High Resolution Computerized Tomography (HRCT) is the gold standard modality to diagnose and stratify severity of bronchiectasis.

Neglected pediatric bronchiectasis is associated with significant morbidity and mortality. So, it should be considered as differential diagnosis in children with recurrent respiratory symptoms as timely and prompt diagnosis is crucial for early intervention. Surgical resection is the last option of treatment for patients with bronchiectasis mainly reserved for those with recurrent infection despite adequate medical therapy.