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Bronchoscopic abnormalities in children with chronic nonspecific cough

Rehab Elmeazawy1, Ahmed M Elniny2, Ahmed Mohamed Abdel Razik2

  • 1Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt. rehab.elmeazawy@med.tanta.edu.eg.

BMC Pediatrics
|May 19, 2026
PubMed

Insights

Flexible bronchoscopy is highly effective in diagnosing the causes of chronic cough in children when other tests fail. This method revealed abnormalities in 87.5% of cases, guiding further treatment for pediatric respiratory conditions.

Area of Science:

  • Pediatric Pulmonology
  • Diagnostic Imaging
  • Respiratory Medicine

Background:

  • Chronic nonspecific cough is a frequent and complex issue in pediatric care.
  • Flexible bronchoscopy is essential for diagnosing persistent cough when initial investigations are inconclusive.

Purpose of the Study:

  • To evaluate the diagnostic yield of flexible bronchoscopy in children with unexplained chronic cough.
  • To identify common etiologies and predictors of specific conditions like post-bronchitic syndrome and congenital airway anomalies.

Main Methods:

  • A prospective cross-sectional study involving 64 children (3 months to 18 years) with chronic cough (>4 weeks).
  • Standardized evaluation including clinical assessment, imaging (CXR, HRCT), and pulmonary function tests (in older children).
  • Flexible bronchoscopy with bronchoalveolar lavage (BAL) for cytological and microbiological analysis.

Main Results:

  • Bronchoscopy identified abnormalities in 87.5% of children, primarily purulent secretions and congenital airway anomalies.
  • BAL analysis revealed neutrophilia (95.3%) and positive cultures (20.3%, mainly H. influenzae, S. pneumoniae).
  • Predictive models showed good discriminative ability for post-bronchitic syndrome (AUC=0.809) and excellent performance for congenital airway anomalies (AUC=0.912).

Conclusions:

  • Flexible bronchoscopy offers a high diagnostic yield for pediatric chronic cough unresponsive to non-invasive methods.
  • Further studies comparing its utility against other diagnostic tools are warranted for definitive clinical assessment.
Abstract

Keywords:
Airway anomaliesBronchoalveolar lavageChildrenChronic coughFlexible bronchoscopyProtracted bacterial bronchitis

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