Perm Medical JournalPerm Medical Journal0136-14492687-1408Eco-Vector1923910.17816/pmj36619-26Research ArticleNosologic independence of pediatric protracted bacterial bronchitis in real clinical practice: single-stage continuous cross-sectional studyMazuninaE. S.lenamurena92@mail.ruFurmanE. G.furman1@yandex.ruEvseenkovaT. G.lenamurena92@mail.ruValiulovI. M.lenamurena92@mail.ruE.A. Vagner Perm State Medical UniversityPerm Regional Children’s Clinical Hospital3012201936619262901202029012020Copyright © 2020, Mazunina E.S., Furman E.G., Evseenkova T.G., Valiulov I.M.2020<p><strong>Aim.</strong> To study the clinical and paraclinical features of protracted bacterial bronchitis (PBB), stated according to clinical definition of disease in children with relapsing course of respiratory diseases and a symptom of wet cough for more than 4 weeks.</p>
<p><strong>Materials and methods. </strong>The study included 68 children with relapsing course of respiratory diseases, who have a symptom of wet cough for more than 4 weeks. Group 1 enclosed 30 (44 %) children, who corresponded to clinical definition of PBB. Group 2 38 (56 %) children without PBB manifestations.</p>
<p><strong>Results.</strong> Bronchial asthma (46.6%, <em>p </em> 0.05), degree 2-3 tracheobronchomalacia (30 %, <em>p</em> 0.05) were more common in the group of children with clinical PBB. No any allergic pathology was observed in 13 (44.8 %) children with PBB. Among the main clinical features of PBB there were observed the following: the presence of night cough (73.3 %, <em>p</em> 0.05), fine moist rales in the lungs (76.6 %), bronchoscopically the presence of diffuse catarrhal-purulent endobronchitis (86.6 %).</p>
<p><strong>Conclusions.</strong> Physicians should bear in mind one of the most frequent causes of protracted wet cough (more than 4 weeks), namely, PBB. When suspecting PBB, a patient should be sent to pulmonologist, undergo bronchoscopy and BAL by indications so as to assess microbial landscape in children with protracted productive cough and rales for a timely diagnosis of PBB and administration of antibacterial therapy.</p>Chronic coughproductive coughwet coughprotracted bacterial bronchitischildrenХронический кашельвлажный кашельпродуктивный кашельзатяжной бактериальный бронхитдети[Овсянников Д.Ю., Бойцова Е.В., Фурман Е.Г., Мазунина Е.С. Ведение детей с хроническим влажным кашлем и затяжным бактериальным бронхитом по материалам рекомендаций экспертной группы CHEST 2017 года. Педиатрия 2018; 97 (2): 157–162.][Рачинский С.В., Таточенко В.К., Артамонов Р.Г. Болезни органов дыхания у детей: руководство для врачей. М.: Медицина 1987; 496.][Фурман Е.Г., Мазунина Е.С., Бойцо- ва Е.В., Овсянников Д.Ю. Затяжной бактериальный бронхит у детей – «новая» «старая» болезнь. Педиатрия 2017; 96 (2): 136–144.][Фурман Е.Г., Пономарева М.С., Корюкина И.П. Диагностика бронхиальной астмы у детей. ГБОУ ВПО ПГМА им. ак. Е.А. Вагнера Минздрава. Пермь: Пресстайм 2013; 197.][Arnold S.R., Bush A.J. Decline in inappropriate antibiotic use over a decade by pediatricians in Tennessee community. Ambulatory Pediatrics: Official Jornal of Ambulatory Pediatric Association 2006; 6: 225–229. DOI: 10.1378/chest.129.5.1132][Chang A.B., Oppenheimer J.J., Weinberger M.M., Rubin B.K., Grant C.C., Kelly Weir, Irwin R.S. Management of сhildren with chronic wet cough and protracted bacterial bronchitis: CHEST Guideline and Expert Panel Report. Chest 2017; 151 (4): 884. DOI: 10.1016/j.chest.2017.01.025][Marchant J.M., Masters I.B., Taylor S.M., Cox N.C., Seymour G.J., Chang A.B. Evaluation and outcome of young children with chronic cough. CHEST Journal 2006; 129 (5): 1132–1141. DOI: 10.1016/j.chest.2017.01.025][Wallis C. ERS statement on tracheomalacia and bronchomalacia in children. European Respiratory Journal 2019; 54 (3): 1900382.][Zhonghua Er Ke Za Zhi. Guideline for diagnosis and treatment of chronic cough in Chinese children. Chinese Journal of Pediatrics 2014; 52: 184.]