Bronchiectasis and Suppurative Bronchitis

Bronchiectasis and other suppurative bronchitic disorders including protracted bacterial bronchitis, primary ciliary dyskinesia and cystic fibrosis are among the important causes of chronic wet cough in children. These suppurative disorders share a common feature of chronic airway inflammation (bronchitis) although the pathogenesis leading to lung damage is not fully understood. The use of flexible bronchoscopy (FB) in the diagnosis and management of these entities has been increasing worldwide albeit with limited clinical research data on its exact role. The increasing popularity of FB in the area allows substantial opportunistic research to gain better understanding of these endobronchial infections. This chapter gives a brief overview of each disease and then discusses the role of flexible bronchoscopy in children with chronic suppuration. Common bronchoscopic findings, both macroscopic (from direct visualization) and microscopic (from bronchoalveolar lavage fluid), are presented for all of these suppurative disorders followed by a review on some specific findings encountered in each entity.