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Think protracted bacterial bronchitis in children with unexplained chronic wheeze, cough
Kompare M. J Pediatr. 2011;doi:10.1016/j.jpeds.2011.06.049.
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Infants and young children with otherwise unexplained chronic cough, wheeze or noisy breathing may have protracted bacterial bronchitis, which may be related to tracheal or bronchial malacia, according to research published online this month.
Miles Weinberger MD, professor of pediatrics in the Division of Allergy, Immunology and Pulmonology at the University of Iowa College of Medicine, and colleagues reviewed medical records of children aged up to 5 years who were seen at their facility between 1999 and 2009 with various symptoms, including, wheezing, noisy breathing or coughing.
The researchers detected Haemophilus influenza, Moraxella catarrhalis or Streptococcus pneumoniae separately or combined in 70 of the children.
“Tracheomalacia, bronchomalacia or both was present in 52 of those children (74%),” the study researchers wrote. They also noted the presence of neutrophilia in 87% of bacteria colonized from bronchoalveolar lavage.
The researchers said the symptoms were eliminated with antibiotics in almost all of the patients, but relapse was common, occurring in 43 children.
“Analogous to otitis media, the bacteria involved are commonly found in the nasal- and oro-pharynx that become pathogenic when trapped in areas where they are not supposed to be, such as the middle ear and the distal airway.” Weinberger said in an email interview with Infectious Diseases in Children. “An initial viral respiratory tract infection is commonly an initiating factor for both bacterial otitis media and protracted bacterial bronchitis.”
Disclosure: The researchers report no relevant financial disclosures.
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