| Objective: protracted bacterial bronchitis(PBB)is one of the most overlooked causes of chronic wet cough in children.PBB without timely and effective standardized treatment can lead to chronic suppurative lung disease(CLSD)and bronchiectasis(BE).However,clinical diagnostic criteria is currently non-specific;thus,PBB may be misdiagnosed.Thus,we assessed the diagnostic value of fiberoptic bronchoscopy(FOB)and risk factors associated with PBB.Methods: Children with chronic cough at First Affiliated Hospital of Anhui Medical University from January 2015 to May 2020 were enrolled and allocated to a PBB(n=141)or a non-PBB(n=206)group.All children underwent extensive laboratory(Including blood routine,liver function,kidney function,immunity eleven,etc),chest imaging examination,and 23 tests for allergen.Children with PBB underwent FOB with bronchoalveolar lavage,submitted lavage fluid samples for examination and cultured pathogenic microorganisms.Results: The mean duration of cough in both groups was approximately 2 months.The mean(SD)age of the included children with PBB was 3.90(1.75,6.03)years,and the male to female ratio was approximately 3:2.The mean(SD)age of non-PBB children was 3.34(1.23,6.00)years,and the male to female ratio was about 2:1,No statistical differences were observed between the age or gender groups(P > 0.05).Of 141 children with suspected PBB,140 received FOB with bronchoalveolar lavage.Visible tracheal changes included pale mucosa,mucosal congestion,edema,swelling,and increased secretions attached to the wall.The properties of the secretions include foamy sputum,thin sputum,and viscous sputum.Sputum was visible primarily in the left main bronchus(78.7%),left lower lobe(59.6%),right upper lobe(62.4%),and right lower lobe(64.5%).Sputum properties and amounts significantly differed between children with vs.without PBB(P < 0.05).Dermatophagoides(odds ratio [OR],2.642;95% CI,1.283–5.369)and milk protein(OR,2.452;95% CI,1.243–4.836)allergies and eczema(OR,1.763;95% CI,1.011–3.075)were risk factors significantly associated with PBB.Conclusion: Dermatophagoides,milk protein,and eczema were associated with increased risk of PBB.Sputum distribution and tracheal wall changes observed through FOB may distinguish PBB and assist in its diagnosis.Bronchoalveolar lavage is conducive to the rapid relief of clinical symptoms in children by flushing out a large number of endobronchial secretions. |
