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Malacia, inflammation and bronchoalveolar lavage culture in children with persistent respiratory symptoms.
- Source :
-
The European respiratory journal [Eur Respir J] 2012 Feb; Vol. 39 (2), pp. 392-5. Date of Electronic Publication: 2011 Jul 20. - Publication Year :
- 2012
-
Abstract
- In children with persistent respiratory symptoms despite regular anti-asthma inhalation treatment, diagnostic investigations to exclude underlying disease are warranted. 124 children were prospectively enrolled, and 24-h oesophageal pH measurement and fibreoptic bronchoscopy with bronchoalveolar lavage (BAL) were performed. BAL fluid (BALF) was processed for neutrophil counting and bacterial culture. Inflammation of the respiratory mucosa was assessed. A structural abnormality of the central airways was found in 47% of subjects (40% females). In 19% of subjects, neither anatomical anomalies nor inflamed respiratory mucosa were observed, whereas in 64%, definite macroscopic mucosal inflammation was observed. Inflammation of the respiratory mucosa was associated with a significantly higher percentage of neutrophils in the BALF: median (interquartile range) 48 (14-82)% compared with 7 (0-16)% (p<0.025). A positive BALF culture was found in 62% of the infants with mucosal inflammation compared with 25% in the group without inflammation (p<0.016). 56% of the BALF samples were positive for bacterial culture. In children with persistent respiratory symptoms, nearly half have anatomical anomalies of the central airways. In 62% of the children with mucosal inflammation, a positive BAL culture and a significantly higher percentage of BALF neutrophils were detected.
- Subjects :
- Bronchoalveolar Lavage Fluid cytology
Bronchoalveolar Lavage Fluid immunology
Bronchoscopy
Cough epidemiology
Cough immunology
Cough pathology
Female
Humans
Infant
Laryngomalacia epidemiology
Laryngomalacia pathology
Male
Neutrophils cytology
Pneumonia epidemiology
Pneumonia pathology
Pneumonia, Bacterial epidemiology
Pneumonia, Bacterial pathology
Prevalence
Prospective Studies
Respiratory Mucosa immunology
Respiratory Mucosa pathology
Respiratory Sounds immunology
Tracheomalacia epidemiology
Tracheomalacia pathology
Laryngomalacia immunology
Pneumonia immunology
Pneumonia, Bacterial immunology
Tracheomalacia immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1399-3003
- Volume :
- 39
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The European respiratory journal
- Publication Type :
- Academic Journal
- Accession number :
- 21778166
- Full Text :
- https://doi.org/10.1183/09031936.00035111