Evaluation and outcome of young children with chronic cough

被引:308
作者
Marchant, Julie M. [1 ]
Masters, I. Brent
Taylor, Simone M.
Cox, Nancy C.
Seymour, Greg J.
Chang, Anne B.
机构
[1] Royal Childrens Hosp, Dept Resp Med, Brisbane, Qld 4029, Australia
[2] Royal Brisbane Hosp, Dept Cytol, Brisbane, Qld 4029, Australia
[3] Univ Queensland, Dept Dent, Brisbane, Qld 4067, Australia
基金
英国医学研究理事会;
关键词
airway inflammation; BAL; bronchitis; chronic cough; children; etiology; investigation; management;
D O I
10.1378/chest.129.5.1132
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To evaluate the use of an adult-based algorithmic approach to chronic cough in a cohort of children with a history of > 3 weeks of cough and to describe the etiology of chronic cough in this cohort. Methods: A prospective cohort study of children referred to a tertiary hospital with a history of > 3 weeks of cough between June 2002 and June 2004. All included children followed a pathway of inv estigation (including flexible bronchoscopy and evaluation of airway cytology via BAL) until diagnosis was made and/or their cough resolved. Results: In our cohort of 108 young children (median age 2.6. years), the majority bad wet cough (n = 96; 890 %), and BAL fluid samples obtained during bronchoscopy led to a diagnosis in 45.4% (n = 49). The most common final diagnosis was priotrueted bacterial bronchitis (n = 43; 39.8%). These patients had neutrophil levels on BAL samples that were significantly higher than those in other diagnostic groups (p < 0.0001). Asthma gastroesophageal reflux disease (GERD), and upper airway cough syndrome (UACS), which are common causes of chronic cough in adults, were found in < 10% of the cohort (n = 10). Conclusions: The adult-based anatomic pathway, which involves the investigation and treatment of patients with asthma, GERD, and UACS first is largely unsuitable for use in the management of chronic cough in young children as the common etiologies of chronic cough in children are different from those in adults.
引用
收藏
页码:1132 / 1141
页数:10
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