A Case Of Bronchiectasis Secondary To Persistent Bacterial Bronchitis And Literature Review

Objective:To explore the clinical characteristics of bronchiectasis secondary to persistent bacterial bronchitis,and to improve the comprehensive and systematic understanding of bronchiectasis secondary to persistent bacterial bronchitis,so as to reduce misdiagnosis and missed diagnosis.Methods:The clinical data of a child with persistent bacterial bronchitis complicated with bronchiectasis were analyzed in detail,including the characteristics,clinical manifestations,auxiliary examinations,diagnosis and treatment,and the related literature was reviewed.Results: In the past five years,the children have coughed repeatedly,accompanied by phlegm,especially in the morning.Oral medication was given at the local clinic.When the symptoms were alleviated,she stopped taking oral medicines.One year ago,bronchiectasis was shown by CT in a provincial third-class A hospital.Bronchoalveolar lavage with fiberoptic bronchoscope was performed.Bronchiectasis(lower lobes of both lungs)was diagnosed by microscopy.No bacterial growth was observed in lavage fluid culture.Symptoms improved after anti-infection treatment and discharged from hospital.During the period,the children still had intermittent cough and sputum.More than four months ago,she was admitted to our hospital.CT examination showed multiple bronchiectasis with infection and mucus embolism in both lungs.The left lung showed large area with small airway inflammation.She was treated with anti-infection,phlegm relief,immunity regulation,glucocorticoid and bronchodilator combined with aerosol inhalation and bronchoscopic lavage.Then she was discharged from hospital better and regulared oral drugs outside Hospital.The child did not cough significantly,but occasionally cough white sticky phlegm on the back of the beat.One day before admission,the cough of the child was heavier than before,accompanied by blood in the sputum,and the symptoms of the child improved after the patient was given conservative treatment such as anti-infection,anti-inflammation,and hemostasis.Conclusion: Protracted bacterial bronchitis is one of the potential risk factors of bronchiectasis.We should recognize the risk and harm of secondary bronchiectasis caused by persistent bacterial bronchitis,early diagnosis,timely treatment,improve the prognosis of patients and improve the quality of life.