Bronchiectasis in Children

Bronchiectasis is the abnormal and permanent expansion of the bronchi as a result of damage to the airways (bronchi) within the lung.

Bronchiectasis may occur in one part of the lung or may develop in both lungs.

Once bronchiectasis occurs. It is difficult to reverse this situation over time.

Although the diagnosis of bronchiectasis is often made in adult patients, it is known that the damage to the bronchi begins in childhood.

The main causes of bronchiectasis in children are infections.

>

In addition to bacterial infections, viral and fungal infections cause bronchiectasis. Bronchiectasis may develop, especially as a result of severe lower respiratory tract infections.

• Pneumonia

• Tuberculosis

• Whooping cough 

• Measles is important. Adenovirus, influenza and fungal infections can cause bronchiectasis.

Bronchiectasis may develop for many reasons other than infection.

• Congenital lung development. deficient children.

• Cystic fibrosis

• Primary ciliary dyskinesia

• Immunodeficiency

• Alpha1 – Antitrypsin deficiency

• Foreign body aspiration and  

• Bronchiectasis may develop in children with gastroesophageal reflux. The incidence of bronchiectasis in these patients is quite low compared to infections.

Clinical symptoms of bronchiectasis

• Bronchiectasis should be considered in children with persistent cough.

Cough attacks increase in these children during the winter months and following infections.

A cough with phlegm is observed, sometimes accompanied by bloody sputum. Vomiting may also occur following coughing fits in children who cannot expectorate sputum.

• It is observed that children with bronchiectasis get tired easily and wheezing attacks occur after activity.

• Response to asthma treatment is sufficient in children followed with a diagnosis of asthma. If not, but has frequent lung infections and produces yellow-green mucous sputum, then bronchiectasis  ; should be considered.

Diagnosis in bronchiectasis:

The patient's history is very important. The nature of the cough, the cough pattern and the infections it has should be carefully examined.

In patients;

• Sputum examination

• Sweat test

• Blood test to identify the immune system

• Bronchoscopy may be performed.

The main diagnostic method is computed lung tomography. High-resolution computer tomography (HRCT) is helpful in diagnosis. This test should be performed in every patient with suspected bronchiectasis.

It is not possible to eliminate bronchiectasis. If the factor causing lung damage is identified, it is important to eliminate this factor.

Treatment of active infection should be started immediately. Antibiotic treatment is important in bronchiectasis. Long-term antibiotic treatment and, in necessary cases, antibiotic prophylaxis may be recommended.

• Antibiotics

                Orally

                   Intravenous.

                   It can be given as nebulized (in steam).

Nebulizer treatment is available for some antibiotics and in this approach, it is recommended with the assumption that antibiotics have no systemic effect and only affect the lungs.

<

Mucolytic agents (expectorant)

Bronchodilators are given to relieve the patient's dense phlegm.

Surgical treatment should be performed in necessary cases.

Lung physiotherapy is important in children with bronchiectasis. The aim is to soften and remove phlegm by giving different positions with breathing exercises accompanied by a physiotherapist.

 

_{Read: 0}