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Clinical Analysis of Bronchiectasis in Taiwanese Children.

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Author(s): Shen-Hao Lai | Kin-Sun Wong | Sui-Ling Liao

Journal: Chang Gung Medical Journal
ISSN 2072-0939

Volume: 27;
Issue: 02;
Start page: 122;
Date: 2004;
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Keywords: bronchiectasis | children.

ABSTRACT
Background: The clinical features and etiology of bronchiectasis have rarely beendescribed in non-Caucasian populations, of whom the prevalence of cysticfibrosis is low. In this report, we studied the clinical features of bronchiectasisin Taiwanese children.Methods: Using a retrospective chart review, 29 cases of bronchiectasis were diagnosedfrom 1991 through 2001. For each case, the diagnosis was confirmedusing high-resolution computed tomography. Medical records were analyzedfor demographic data, clinical presentation, spirometric data, and microbialisolation. Radiographic findings were reviewed, and possible causes ofbronchiectasis were also identified.Results: There were 17 girls and 12 boys enrolled. Persistent cough, daily sputumproduction, and hemoptysis were common presenting symptoms. Cracklesand wheezing were the most frequent findings during the physical examination.Previous lower airway infection, asthma, and primary immunodeficiencywere the most common, but 31.0% of the cases had unknown causes.Dependent lobes were involved more frequently. Simultaneous sinusitis wasnoted in 70.6% of the cases. Spirometry showed mild airway obstruction inmost of the cases. Most specimens (52.2%) from lower airway secretionsyielded bacterial pathogens, most commonly Pseudomonas aeruginosa,Haemophilus influenzae and Streptococcus pneumoniae.Conclusion: Continuing post-infectious inflammatory changes remains the most importantcause of bronchiectasis in a non-Caucasian pediatric population inNorthern Taiwan in the 1990s. More than two thirds of these patients hadunderlying predisposing factors including asthma, immunodeficiency, andswallowing dysfunction. Chronic productive purulent respiratory secretionsand persistent crackles should raise the possibility of bronchiectasis in childreneven in Taiwan where the incidence of cystic fibrosis is low.

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