Bronchiectasis: Causes, Symptoms, and Diagnosis

Bronchiectasis is a disease of the airways inside the child's lungs. In bronchiectasis the airways get damaged which leads to airways becoming widened and flabby. In addition the damaged airways cannot clear out mucus or phlegm leading to its accumulation. The accumulated mucus attracts bacteria leading to frequent infections which further damages the airway wall. This is a cycle which keeps going on leading to continuous and increasing trouble.

What Are the Symptoms of Bronchiectasis in children?
The most common symptoms of bronchiectasis in children is a persistent wet cough. Most children with viral infections have a wet cough but get well in 10-14 days. If children keep on having a cough with mucus or phlegm even after the viral infection especially beyond 6-8 weeks bronchiectasis should be suspected. Other symptoms of Bronchiectasis in children are coughing up yellow mucus and coughing up blood (called hemoptysis). Children can have wheezing or whistling sounds while breathing, shortness of breath and chest pain.

Children with Bronchiectasis can also have periods of increased cough with yellow/green with or without fever called as Bronchiectasis flares or exacerbations.

What are the common causes of bronchiectasis in children?
The commonest cause of Bronchiectasis in developing countries like India is lung infections like severe pneumonia, tuberculosis, whooping cough or pertussis and

  • whooping cough. Allergic bronchopulmonary aspergillosis also is an important cause of Bronchiectasis seen in India.
  • The other common cause of bronchiectasis in children is genetic problems cystic fibrosis and primary ciliary dyskinesia.
  • Diseases which lead to low immunity (termed immunodeficiency) also is a common cause of bronchiectasis in children. These conditions are common variable immunodeficiency, X linked agammaglobulinemia, IgA deficiency and chronic granulomatous disease.
  • A long standing foreign body in the airway can also lead to bronchiectasis.
  • Other causes seen are chronic aspiration in children having neurological illnesses and connective tissue diseases such as rheumatoid arthritis etc.

What investigations are required in children with Bronchiectasis?
All children with Bronchiectasis require detailed investigations for diagnosis of Bronchiectasis and its cause. Best investigation for diagnosis of Bronchiectasis is a CT SCAN of the chest. The airways inside the lungs can be seen in detail. For diagnosis of cause of bronchiectasis investigations such as sweat chloride analysis, immunodeficiency workup and bronchoscopy might be required.

How do we treat Bronchiectasis?
Treatment of Bronchiectasis requires good chest physiotherapy to regularly drain the mucus and hence prevent its accumulation. Children with Bronchiectasis exacerbations also require antibiotics for treatment of infection.

Specific treatment of the cause of bronchiectasis is essential to stop the progression of the disease.

If your child gets frequent wet coughs or persistent cough or repeated pneumonias the child needs investigations for Bronchiectasis. Get in touch with a child chest specialist for proper diagnosis and treatment advice.

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