A pediatric disease to keep in mind: diagnostic tools and management of bronchiectasis in pediatric age

Ital J Pediatr. 2017 Dec 29;43(1):117. doi: 10.1186/s13052-017-0434-0.

Abstract

Bronchiectasis in pediatric age is a heterogeneous disease associated with significant morbidity.The most common medical conditions leading to bronchial damage are previous pneumonia and recurrent lower airway infections followed by underlying diseases such as immune-deficiencies, congenital airway defects, recurrent aspirations and mucociliary clearance disorders.The most frequent symptom is chronic wet cough. The introduction of high-resolution computed tomography (HRCT) has improved the time of diagnosis allowing earlier treatment.However, the term "bronchiectasis" in pediatric age should be used with caution, since some lesions highlighted with HRCT may improve or regress. The use of chest magnetic resonance imaging (MRI) as a radiation-free technique for the assessment and follow-up of lung abnormalities in non-Cystic Fibrosis chronic lung disease is promising.Non-Cystic Fibrosis Bronchiectasis management needs a multi-disciplinary team. Antibiotics and airway clearance techniques (ACT) represent the pillars of treatment even though guidelines in children are lacking. The Azithromycin thanks to its antinflammatory and direct antimicrobial effect could be a new strategy to prevent exacerbations.

Keywords: Airway clearance techniques; Antibiotics; Azithromycin; Children bronchiectasis; chronic wet cough; HRCT; MRI.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Bronchiectasis / complications*
  • Bronchiectasis / diagnostic imaging
  • Child
  • Child, Preschool
  • Chronic Disease
  • Cough / diagnostic imaging
  • Cough / epidemiology
  • Cough / etiology*
  • Disease Management
  • Female
  • Global Health
  • Humans
  • Infant
  • Magnetic Resonance Imaging / methods*
  • Male
  • Pneumonia / diagnostic imaging
  • Pneumonia / epidemiology
  • Pneumonia / etiology*
  • Prognosis
  • Risk Assessment
  • Tomography, X-Ray Computed / methods*