Paeds Cases · respiratory-sleep-and-airway
Bronchiectasis in children — clinical case
Clinical case of a school-aged child with a chronic wet cough progressing to bronchiectasis, illustrating the suppurative lung disease continuum, the aetiological work-up, and airway-clearance-and-antibiotic management.
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Case summary
This girl presents with the defining picture of chronic suppurative lung disease: a daily wet cough lasting six months that briefly improves with antibiotics but never clears, in a child who is never really well. The essential clinical insight is that a wet cough recurring after antibiotics is not a run of viruses but an airway that cannot clear itself, and with early digital clubbing, faltering growth, and a fixed focal chest sign she has crossed from ordinary recurrent illness into established suppurative disease heading toward bronchiectasis. [1] [2]
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- [1]Chang AB, Bush A, Grimwood K Bronchiectasis in children: diagnosis and treatment. Lancet, 2018.PMID 30215382
- [2]Chang AB, Bell SC, Torzillo PJ, et al Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand Thoracic Society of Australia and New Zealand guidelines. Med J Aust, 2015.PMID 25588439
- [3]Goyal V, Grimwood K, Byrnes CA, et al Amoxicillin-clavulanate versus azithromycin for respiratory exacerbations in children with bronchiectasis (BEST-2): a multicentre, double-blind, non-inferiority, randomised controlled trial. Lancet, 2018.PMID 30241722