Pediatric Infectious Diseases: Open Access

Bronchoscopic Abnormalities in Pediatric Chronic Cough: A Case-Control Study

Background: Lower airway abnormalities, inflammation and bacterial infection are frequently described in children with chronic cough but its frequency in asymptomatic children is unknown. We report bronchoscopic abnormalities observed in children with chronic cough and in children undergoing fiberoptic bronchoscopy for causes other than chronic cough. Methods and findings: Retrospective case-control cohort study. The clinical records of children who had fiberoptic bronchoscopy for a history of chronic cough between 2008 and 2014 and of control children who required fiberoptic bronchoscopy for other causes were reviewed. Bronchoscopic findings and bronchoalveolar lavage results were assessed. Cases were 50 [27 female, median age 5.5 (0.5-12) years]. Their cough was wet in 37 (74%). Controls were 29 [12 female, median age 5.6 (0.5-14) years]. Airway malacia was observed in 25 cases (50%) vs 4 controls (14%) (p=0.001) and profuse secretions in 22 (44%) vs 6 (21%) (p = 0.03). When bronchoalveolar lavage was performed relevant organisms were isolated in 18 (45%) cases vs 4 (18%) controls (p=0.03). H influenzae (9), M catarrhalis (4) and S pneumonia (3) were seen only in cases. Polymerase chain reaction to viruses was positive in 13 (33%) cases vs 4 (14%) controls (p=0.04). Similar viruses were found in both: Rhinovirus and Adenovirus. Conclusions: Airway abnormalities were observed in seven out of ten cases the commonest one being airway malacia. It was associated with a higher frequency of positive cultures mostly for non typable H. influenzae and M. catarrhalis which were not isolated in controls. Similar viruses (Rhinovirus and Adenovirus) were found in both groups, although isolation was more frequent in cases.

Author(s):

Mikel Santiago-Burruchaga, Estibaliz Catediano-Sainz, Rafael Zalacain- Jorge and Carlos Vazquez- Cordero

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