| Background:Protracted bacterial bronchitis(PBB) is mainly marked by wet cough lasting more than4weeks and it should exclude the other particular reasons. PBB can be completely relieved by using proper course of sensible antibioti. Chronic cough is very common in children and it can be divided into two parts:wet cough and dry cough. PBB is a common cause in chronic wet cough and it is also a common cause of chronic cough in Children under6years old. Although there are many related researches and documents abroad, PBB has not yet been fully understanded in our country. PBB is often misdiagnosed as bronchial asthma and as a result it is often incurable. PBB may develop into chronic suppurative lung disease and bronchiectasis if the treatment is not directed on persistent infection and the accompanying inflammation. In recent years, pediatricians are taking their attentions on PBB.Aim:To observe the clinical characteristics, treatment and outcome of children with PBB. To analyse the pathogen characteristics. To provide basis for the diagnosis and treatment of PBB.Methods:28children who had PBB were chosen in pediatrics of Tengzhou Central People’s Hospital from July2010to Sep2014. The ages were from6months to75months.17were boys and11were girls. Collected their clinical information including the age, sex, past history, allergic history, characteristic of cough and wheeze. Blood routine, liver function, myocardial enzymes and anaphylactogen should be done. Detected the pathogen including blood culture, sputum culture, pneumoslide IgM, mycoplasma pneumoniae antibody. Detected the subset, immunoglobulin and complement. Took X-RAY and HRCT scanning. Electronic bronchoscopy and bronchoalveolar lavage were given in8children. All the children were treated with antibiotics and6of them had used budesonide.Results:1.Clinical characteristic:The age was between6months and75months, and the susceptible age was between6months and36months. Of the28children,17were boys (64%) and11were girls (36%).All children had wet cough lasting4to9weeks when they come to the hospital.16(57%) had moist rales.5(18%) had dry rales.6(21%) had cephalus puadratas.4(14%) had fever.6(21%) had mild anemia.4(14%) had liver damage.6(21%) had myocardial damage.7(25%) were premature babies.5(18)were low birth weight infant.4(14%) had eczema and5(18%) had anaphylaxis disease in their families.2. Etiology:Sputum culture:There are10(36%) cases with haemophilus influenzae infection,8(29%) cases with streptococcus pneumoniae infection,6(21%) with moraxelle catarrhalis infection,2(7%) with klebsiella pneumoniae infection.Bronchoalveolar lavage fluid culture:There are2(25%) cases with haemophilus influenzae infection,1(13%) cases with streptococcus pneumoniae infection.3.X-RAY and HRCT:The X-RAY had no special changes.15(54%) showed enlarged lung marking.4(14%) had patchy consolidation.9(32%) had no obvious abnormalities.HRCT were taken in12cases.6(50%) had no obvious abnormalities.2(17%) had bronchial wall thickening.2(17%) had mosaic infusions.4weeks after the treatment, mosaic infusions disappeared.4.1mmunoglobulin:IgG decreased in9cases (60%), IgA decreased in7cases (47%), IgM increased in lease (7%).5.Electronic bronchoscopy:All the8cases that had been given electronic bronchoscopy and bronchoalveolar lavage had inflammation.8(100%) had bronchial mucosa congestion and edema.4(50%) had tracheal and bronchial mucosa longitudinal folds.6(67%) had sputum bolt on some lung lobe.2(25%) had sputum bolt on bronchus opening.4(50%) had bronchial softening.All the children had different degrees of reduction in number of macrophages, and at the same time had increase in number of neutrophil number.6.Treatments and Outcomes:All the children were given antibiotics sensitive.17(61%) cases were treated with amoxicillin and clavulanate potassium.8(29%) examples were given the third generation cephalosporin.3(11%) cases were treated with azithromycin. The course of antibiotics sensitive in all the children were more than2weeks. All the children were cured in the end.Conclusions:1. Children less than3years are more likely to suffer from PBB.2. Respiratory infection is the common causative factors of children with PBB.3. Haemophilus influenza, Streptococcus pneumonia and Moraxella catarrhalis are the main pathogeny in PIBO.4. PBB can be resolved with proper course of sensible antibiotic. |
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