Etiology and outcome of bronchiectasis in children: a study of 41 patients.
BACKGROUND
Bronchiectasis remains an important cause of chronic suppurative lung disease in the developing world. The aim of this study is to describe the epidemiological characteristics, clinical features, underlying aetiologies and outcome of bronchiectasis in the paediatric hospital of Tunis.


METHODS
A retrospective study of 41 children with bronchiectasis was conducted between January 1994 and December 2006. Diagnosis was made in patients with clinical suspicion of bronchiectasis associated with abnormalities on chest X ray (n=37) and/or on high resolution computed tomography (HRCT) (n=36).


RESULTS
Mean age at diagnosis was 5 years 9 months; (range: 6 months-14 years). Persistent cough and bronchorrhea were the most common symptoms. Fourteen patients (34%) had dyspnoea on first presentation, 11 of them (26.8%) had chest deformation and/or finger clubbing. Haemoptysis was noted in only two cases. Mean time to diagnosis from symptom onset was 2.7 years (range: 2 months-4 years). The underlying aetiologies were identified in 52% of patients. Cystic fibrosis (17%), previous pneumonic illness (9.7%), primary ciliary dyskinesia (9.7%) and immunodeficiency (9.7%) were the most common causes. After a mean follow-up of 6.6 years, the annual lower respiratory infection rate decreased from 7.2 +/- 3 to 3.1 +/- 2.6 (p<0.05), Twenty one point nine per cent of patients had chronic respiratory failure and five patients required surgery.


CONCLUSIONS
Delays diagnosis of bronchiectasis remains important in our country. Congenital and indeterminate aetiologies are the most common forms. Prognosis is poor with a high prevalence of chronic respiratory failure.
Bouyahia
Olfa
O
Paediatric Department C, Paediatric Hospital of Tunis, Tunisia.
Essadem
Leila
L
Matoussi
Nadia
N
Gharsallah
Lamia
L
Fitouri
Zohra
Z
Mrad Mazigh
Sonia
S
Boukthir
Samir
S
Bellagah
I
I
Ben Becher
Saida
S
Sammoud El Gharbi
Azza
A
D000293:Adolescent; D001987:Bronchiectasis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D003550:Cystic Fibrosis / Q000150:complications; D004417:Dyspnea / Q000209:etiology; D006469:Hemoptysis / Q000209:etiology; D006776:Hospitals, Pediatric; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications; D015994:Incidence; D007223:Infant; D007619:Kartagener Syndrome / Q000150:complications; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013183:Sputum / Q000378:metabolism; D013909:Thorax / Q000002:abnormalities; D014416:Tunisia / Q000453:epidemiology