Chronic wet cough

Protracted bronchitis, chronic suppurative lung disease and bronchiectasis

Anne Chang, G Redding, M Everard

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    The role of persistent and recurrent bacterial infection of the conducting airways (endobronchial infection) in the causation of chronic respiratory symptoms, particularly chronic wet cough, has received very little attention over recent decades other than in the context of cystic fibrosis (CF). This is probably related (at least in part) to the (a) reduction in non-CF bronchiectasis in affluent countries and, (b) intense focus on asthma. In addition failure to characterize endobronchial infections has led to under-recognition and lack of research. The following article describes our current perspective of inter-related endobronchial infections causing chronic wet cough; persistent bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis. In all three conditions, impaired muco-ciliary clearance seems to be the common risk factor that provides organisms the opportunity to colonize the lower airway. Respiratory infections in early childhood would appear to be the most common initiating event but other conditions (e.g., tracheobronchomalacia, neuromuscular disease) increases the risk of bacterial colonization. Clinically these conditions overlap and the eventual diagnosis is evident only with further investigations and long term follow up. However whether these conditions are different conditions or reflect severity as part of a spectrum is yet to be determined. Also misdiagnosis of asthma is common and the diagnostic process is further complicated by the fact that the co-existence of asthma is not uncommon. The principles of managing PBB, CSLD and bronchiectasis are the same. Further work is required to improve recognition, diagnosis and management of these causes of chronic wet cough in children. � 2008 Wiley-Liss, Inc.
    Original languageEnglish
    Pages (from-to)519-531
    Number of pages13
    JournalPediatric Pulmonology
    Volume43
    Issue number6
    Publication statusPublished - 2008

    Fingerprint

    Bronchiectasis
    Chronic Bronchitis
    Cough
    Lung Diseases
    Asthma
    Tracheobronchomalacia
    Infection
    Neuromuscular Diseases
    Diagnostic Errors
    Bacterial Infections
    Cystic Fibrosis
    Respiratory Tract Infections
    Causality
    Fibrosis
    Research

    Cite this

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    abstract = "The role of persistent and recurrent bacterial infection of the conducting airways (endobronchial infection) in the causation of chronic respiratory symptoms, particularly chronic wet cough, has received very little attention over recent decades other than in the context of cystic fibrosis (CF). This is probably related (at least in part) to the (a) reduction in non-CF bronchiectasis in affluent countries and, (b) intense focus on asthma. In addition failure to characterize endobronchial infections has led to under-recognition and lack of research. The following article describes our current perspective of inter-related endobronchial infections causing chronic wet cough; persistent bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis. In all three conditions, impaired muco-ciliary clearance seems to be the common risk factor that provides organisms the opportunity to colonize the lower airway. Respiratory infections in early childhood would appear to be the most common initiating event but other conditions (e.g., tracheobronchomalacia, neuromuscular disease) increases the risk of bacterial colonization. Clinically these conditions overlap and the eventual diagnosis is evident only with further investigations and long term follow up. However whether these conditions are different conditions or reflect severity as part of a spectrum is yet to be determined. Also misdiagnosis of asthma is common and the diagnostic process is further complicated by the fact that the co-existence of asthma is not uncommon. The principles of managing PBB, CSLD and bronchiectasis are the same. Further work is required to improve recognition, diagnosis and management of these causes of chronic wet cough in children. � 2008 Wiley-Liss, Inc.",
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    Chronic wet cough : Protracted bronchitis, chronic suppurative lung disease and bronchiectasis. / Chang, Anne; Redding, G; Everard, M.

    In: Pediatric Pulmonology, Vol. 43, No. 6, 2008, p. 519-531.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Chronic wet cough

    T2 - Protracted bronchitis, chronic suppurative lung disease and bronchiectasis

    AU - Chang, Anne

    AU - Redding, G

    AU - Everard, M

    PY - 2008

    Y1 - 2008

    N2 - The role of persistent and recurrent bacterial infection of the conducting airways (endobronchial infection) in the causation of chronic respiratory symptoms, particularly chronic wet cough, has received very little attention over recent decades other than in the context of cystic fibrosis (CF). This is probably related (at least in part) to the (a) reduction in non-CF bronchiectasis in affluent countries and, (b) intense focus on asthma. In addition failure to characterize endobronchial infections has led to under-recognition and lack of research. The following article describes our current perspective of inter-related endobronchial infections causing chronic wet cough; persistent bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis. In all three conditions, impaired muco-ciliary clearance seems to be the common risk factor that provides organisms the opportunity to colonize the lower airway. Respiratory infections in early childhood would appear to be the most common initiating event but other conditions (e.g., tracheobronchomalacia, neuromuscular disease) increases the risk of bacterial colonization. Clinically these conditions overlap and the eventual diagnosis is evident only with further investigations and long term follow up. However whether these conditions are different conditions or reflect severity as part of a spectrum is yet to be determined. Also misdiagnosis of asthma is common and the diagnostic process is further complicated by the fact that the co-existence of asthma is not uncommon. The principles of managing PBB, CSLD and bronchiectasis are the same. Further work is required to improve recognition, diagnosis and management of these causes of chronic wet cough in children. � 2008 Wiley-Liss, Inc.

    AB - The role of persistent and recurrent bacterial infection of the conducting airways (endobronchial infection) in the causation of chronic respiratory symptoms, particularly chronic wet cough, has received very little attention over recent decades other than in the context of cystic fibrosis (CF). This is probably related (at least in part) to the (a) reduction in non-CF bronchiectasis in affluent countries and, (b) intense focus on asthma. In addition failure to characterize endobronchial infections has led to under-recognition and lack of research. The following article describes our current perspective of inter-related endobronchial infections causing chronic wet cough; persistent bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis. In all three conditions, impaired muco-ciliary clearance seems to be the common risk factor that provides organisms the opportunity to colonize the lower airway. Respiratory infections in early childhood would appear to be the most common initiating event but other conditions (e.g., tracheobronchomalacia, neuromuscular disease) increases the risk of bacterial colonization. Clinically these conditions overlap and the eventual diagnosis is evident only with further investigations and long term follow up. However whether these conditions are different conditions or reflect severity as part of a spectrum is yet to be determined. Also misdiagnosis of asthma is common and the diagnostic process is further complicated by the fact that the co-existence of asthma is not uncommon. The principles of managing PBB, CSLD and bronchiectasis are the same. Further work is required to improve recognition, diagnosis and management of these causes of chronic wet cough in children. � 2008 Wiley-Liss, Inc.

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    KW - beta 2 adrenergic receptor stimulating agent

    KW - bromhexine

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    KW - indometacin

    KW - leukotriene receptor blocking agent

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    KW - mucolytic agent

    KW - nonsteroid antiinflammatory agent

    KW - oxygen

    KW - Pneumococcus vaccine

    KW - tobramycin

    KW - acupuncture

    KW - asthma

    KW - bacterial colonization

    KW - breathing exercise

    KW - bronchiectasis

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    KW - oxygen therapy

    KW - pathogenesis

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    KW - quality of life

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    KW - review

    KW - risk factor

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    KW - Asthma

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    KW - Diagnosis, Differential

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    JO - Pediatric Pulmonology

    JF - Pediatric Pulmonology

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