Unsuspected bacterial suppurative disease of the airways presenting as chronic cough

Schaefer, Oren P.; Irwin, Richard S.

doi:10.1016/s0002-9343(03)00079-2

Cited by 24 publications

(14 citation statements)

References 22 publications

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“…An adult study of PBB proved by bronchoscopy, without bronchiectasis on HRCT, found that even 3 weeks of oral antibiotics failed to clear the cough and all their patients required intravenous antibiotics. 39 The progressive fall in prescribing antibiotics for viral respiratory tract infections in early childhood over the past decade [18][19][20] has been appropriate. However, this may have the consequence of inadvertently increasing the incidence of PBB, and possibly idiopathic bronchiectasis, in the coming decades.…”

Section: Discussionmentioning

confidence: 99%

Outcomes in children treated for persistent bacterial bronchitis

Donnelly

Critchlow

Everard

2007

Thorax

160

147

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Background: Persistent bacterial bronchitis (PBB) seems to be under-recognised and often misdiagnosed as asthma. In the absence of published data relating to the management and outcomes in this patient group, a review of the outcomes of patients with PBB attending a paediatric respiratory clinic was undertaken. Methods: A retrospective chart review was undertaken of 81 patients in whom a diagnosis of PBB had been made. Diagnosis was based on the standard criterion of a persistent, wet cough for .1 month that resolves with appropriate antibiotic treatment. Results: The most common reason for referral was a persistent cough or difficult asthma. In most of the patients, symptoms started before the age of 2 years, and had been present for .1 year in 59% of patients. At referral, 59% of patients were receiving asthma treatment and 11% antibiotics. Haemophilus influenzae and Streptococcus pneumoniae were the most commonly isolated organisms. Over half of the patients were completely symptom free after two courses of antibiotics. Only 13% of patients required >6 courses of antibiotics. Conclusion: PBB is often misdiagnosed as asthma, although the two conditions may coexist. In addition to eliminating a persistent cough, treatment may also prevent progression to bronchiectasis. Further research relating to both diagnosis and treatment is urgently required.

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Section: Discussionmentioning

confidence: 99%

Outcomes in children treated for persistent bacterial bronchitis

Donnelly

Critchlow

Everard

2007

Thorax

160

147

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“…However, in this particular report [58], other than presence of wet or productive cough, other criteria such as duration of cough went undefined. Furthermore, another adult case series [59] described chronic productive cough unrelated to bronchiectasis, which responded only to intravenous antibiotics. However, this requirement for parenteral antibiotics is used to help to differentiate between chronic suppurative lung disease (CSLD) and PBB in children [15].…”

Section: Definition Of Pbb (Kq1)mentioning

confidence: 99%

ERS statement on protracted bacterial bronchitis in children

et al. 2017

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This European Respiratory Society statement provides a comprehensive overview on protracted bacterial bronchitis (PBB) in children. A task force of experts, consisting of clinicians from Europe and Australia who manage children with PBB determined the overall scope of this statement through consensus. Systematic reviews addressing key questions were undertaken, diagrams in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement constructed and findings of relevant studies summarised. The final content of this statement was agreed upon by all members.The current knowledge regarding PBB is presented, including the definition, microbiology data, known pathobiology, bronchoalveolar lavage findings and treatment strategies to manage these children. Evidence for the definition of PBB was sought specifically and presented. In addition, the task force identified several major clinical areas in PBB requiring further research, including collecting more prospective data to better identify the disease burden within the community, determining its natural history, a better understanding of the underlying disease mechanisms and how to optimise its treatment, with a particular requirement for randomised controlled trials to be conducted in primary care.This article has supplementary material available from

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“…In retrospective studies the majority of adult patients with idiopathic bronchiectasis give a history of persistent wet cough from childhood [9,125]. There are very few, if any, descriptions of PBB in adults, although one previous study identified 15 adult subjects with chronic productive cough secondary to 'unsuspected bacterial suppurative disease of the airways' and grossly normal HRCT scans [126].…”

Section: Idiopathic Chronic Productive Coughmentioning

confidence: 99%

Causes of chronic productive cough: An approach to management

Martin

Harrison

2015

Respiratory Medicine

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A chronic 'productive' or 'wet' cough is a common presenting complaint for patients attending the adult respiratory clinic. Most reviews and guidelines suggest that the causes of a productive cough are the same as those of a non-productive cough and as such the same diagnostic pathway should be followed. We suggest a different diagnostic approach for patients with a productive cough, focussing on the conditions that are the most likely causes of this problem. This review is intended to briefly summarise the epidemiology, clinical features, pathophysiology and treatment of a number of conditions which are often associated with chronic productive cough to aid decision making when encountering a patient with this often distressing symptom. The conditions discussed include bronchiectasis, chronic bronchitis, asthma, eosinophilic bronchitis and immunodeficiency. We also propose an adult version of the paediatric diagnosis of protracted bacterial bronchitis (PBB) in patients with idiopathic chronic productive cough who appear to respond well to low dose macrolide therapy.

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Unsuspected bacterial suppurative disease of the airways presenting as chronic cough

Cited by 24 publications

References 22 publications

Outcomes in children treated for persistent bacterial bronchitis

Outcomes in children treated for persistent bacterial bronchitis

ERS statement on protracted bacterial bronchitis in children

Causes of chronic productive cough: An approach to management

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