Evaluation of patients with childhood bronchiectasis

Objective: Bronchiectasis is still an important health problem for lower respiratory tract in children in under developed countries due to insufficiency of health services, poor hygiene conditions, large population. The frequency of bronchiectasis is not known in our country since there is no proper recording system in this area. The purpose of this retrospective study was to evaluate the demographic data of children diagnosed with non-cystic fibrosis bronchiectasis, their age at the time of diagnosis, hospitalization complaints, number and duration of hospitalization time, physical examination findings, laboratory findings, radiological findings, pulmonary function test values, sputum culture growth and their treatment, underlying etiologic factors by hospital file archive and compare them with other studies in this field. Materials and Methods: 110 patients aged between 2 and 17 years old who has diagnosis of cystic non-fibrosis bronchiectasis evaluated between January 2012 and December 2017 at the Department of Pediatrics Dicle University Faculty of Medicine. Gender, age, place of residence, age at the time of diagnosis, etiology, kinship status, family history of similar disease, smoking exposure, immunization status, complaints, physical examination findings, number of hospital admissions, hospitalization season, number and duration of hospitalization, complete blood count, sedimentation, C-reaktif protein (CRP), blood gas, immunoglobulin levels, some biochemical parameters, pulmonary function tests, sputum culture, treatment, antibiotic use, supportive therapies and scanning of affected lobes and bronchiectasis types on computed tomography (CT) and/or high resolution computed tomography data were recorded from patient records. Findings/Results: The mean age at diagnosis was 10,52 ± 3,76 years, the earliest diagnosis was 2 years old and the latest diagnosis was 17 years. 51,8 % of the patients were male and 48,2 % were female. Parental relationship was 28,1 % and 16,4 % of them had similar family history. The most common presenting v symptom was cough with 100 % and the most common physical examination was rael with 73,6 %. 43,6 % of the patients had no underlying cause and 21,8 % had previous lung infection as the most common etiology. The most common type was tubular type bronchiectasis with 58,2 %. The localization of bronchiectasis was bilateral lung involvement in 39,1 %. The most commonly isolated microorganism in sputum cultures was Streptococcus pneumoniae. Surgical treatment was performed in 10 % of the patients. Surgical procedure was lobectomy in all patients. Conclusion: Bronchiectasis should be considered in differential diagnoses if the patient has cough and abundant sputum in physical examination. Family physicians should consider bronchiectasis in patients presenting with chronic sputum cough lasting more than 8 weeks. They should direct these patients to the polyclinics of pediatrics for further examination and treatment. Although the symptoms in bronchiectasis patients start mostly in pre-school and early school years, the diagnosis of bronchiectasis is delayed. When bronchiectasis is diagnosed with a good history and physical examination, and the appropriate treatment regimen is applied, the symptoms will be lighter, the progression of the disease will be prevented, less complications will develop, the patients will be less hospitalized and the quality of life of the patients and their families will be increased. Key Words: Childhood bronchiectasis, cough with sputum, abundant sputum, high resolution computed tomography.