Bronchoscopy contributes to the clinical management of indigenous children newly diagnosed with bronchiectasis

Pizzutto, Susan J., Grimwood, Keith, Bauert, Paul, Schutz, Kobi L., Yerkovich, Stephanie T., Upham, John W. and Chang, Anne B. (2013) Bronchoscopy contributes to the clinical management of indigenous children newly diagnosed with bronchiectasis. Pediatric Pulmonology, 48 1: 67-73. doi:10.1002/ppul.22544

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Author Pizzutto, Susan J.
Grimwood, Keith
Bauert, Paul
Schutz, Kobi L.
Yerkovich, Stephanie T.
Upham, John W.
Chang, Anne B.
Title Bronchoscopy contributes to the clinical management of indigenous children newly diagnosed with bronchiectasis
Journal name Pediatric Pulmonology   Check publisher's open access policy
ISSN 8755-6863
1099-0496
Publication date 2013-01
Year available 2012
Sub-type Article (original research)
DOI 10.1002/ppul.22544
Volume 48
Issue 1
Start page 67
End page 73
Total pages 7
Place of publication Hoboken, NJ, U.S.A.
Publisher John Wiley & Sons
Collection year 2013
Language eng
Formatted abstract Background: Some pediatric centers perform flexible bronchoscopy (FB) routinely when bronchiectasis is suspected. However, there are no published data evaluating this practice.
Objective: To evaluate the contribution of FB and bronchoalveolar lavage (BAL) to the initial management of children newly diagnosed with non-cystic fibrosis (CF) bronchiectasis.
Method: We examined FB and BAL data collected prospectively in 56 children aged 0.8–9.8 years during initial investigations for bronchiectasis. Investigations contributed to management if any of the following were identified: (1) airway obstruction requiring additional intervention, (2) lower airway eosinophilia (BAL eosinophils >2.5%), or (3) BAL fluid culture >104 colony-forming units/ml of a respiratory bacterial pathogen requiring change from usual empiric antibiotics.
Results: Of the 56 children undergoing FB, there were 25 occasions in 23 children where these procedures altered empiric treatment. Lower airway eosinophilia was identified in 19 (34%) children, BAL microbiology results led to antibiotic changes in 5 (9%) and an unsuspected foreign body was found in another (2%). Strongyloides serology was performed in 38 children, including 12 of the 19 with airway eosinophilia, and was positive in 5 of these 12 children (42%).
Conclusion: Contrary to some expert recommendations that FB should only be performed when bronchiectasis is localized, our data suggest that FB with BAL should at least be included in the initial investigations of Indigenous children with non-CF bronchiectasis.
Keyword Chronic suppurative lung disease
Eosinophilia
Foreign body
Strongyloides
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 19 MAR 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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Created: Wed, 11 Jul 2012, 12:29:32 EST by Matthew Lamb on behalf of School of Medicine