Clinical features and therapy of persistent bacterial bronchitis in 31 children

Abstract

To investigate the clinical features and therapy of persistent bacterial bronchitis (PBB). A retrospective review of 31 patients with PBB from Octorber 2010 to May 2014 in Department 2 of Respiratory Diseases in Beijing Children's Hospital was undertaken. (1) The patients (17 boys and 14 girls) were 6 months to 3 years old. The main complaint was chronic wet cough (>4 weeks); 13 cases had fever and 25 cases had wheezing. Rattle was heard on auscultation in all patients. (2) Chest X ray showed an increase in bronchovascular markings in all cases, accompanied by patchy infiltration in 6 cases. The high resolution computed tomography (HRCT) demonstrated bronchial wall thickening in 25 cases, associated with peri-bronchial patchy infiltration in 18 cases, with organized pneumonia in 7 cases ( atelectasis in 5 cases). Centrilobular nodules and ground-glass opacity were observed in the remaining 6 patients. (3) Purulent secretion was seen in endobronchial cavity by bronchoscopy. Streptococcus pneumoniae was isolated from sputum culture or bronchoalveolar lavage fluid culture in 16 patients. (4)Patients recovered completely after over 2 weeks'treatment with amoxicillin-clavulanate or the second and third generation cephalosporin (including enzyme inhibitors) in 28 cases, carbapenems, teicoplanin , linezolid in 1 case respectively. PBB often occurred in 3 years old or younger patients and had chronic wet cough for more than 4 weeks, fever and wheezing. HRCT may reveal bronchial wall thickening, respiratory secretions culture may reveal Streptococcus pneumoniae. Most of patients recovered completely after over 2 weeks'treatment with amoxicillin-clavulanate or the second or third generation cephalosporins (including enzyme inhibitors).