Premium
Wet cough in children: Infective and inflammatory characteristics in broncho‐alveolar lavage fluid
Author(s) -
Wurzel Danielle F.,
Marchant Julie M.,
Clark Julia E.,
Masters I. Brent,
Yerkovich Stephanie T.,
Upham John W.,
Chang Anne B.
Publication year - 2014
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22792
Subject(s) - medicine , neutrophilia , airway , immunology , chronic cough , bronchoalveolar lavage , inflammation , lung , anesthesia , asthma
Summary Wet cough is a common feature of many disease processes affecting children. Our aim was to examine the relationships between cough nature, lower airway infection (bacterial, viral, and viral–bacterial) and severity of neutrophilic airway inflammation. We hypothesized that viral–bacterial co‐infection of the lower airway would be associated with wet cough and heightened neutrophilic airway inflammation. We prospectively recruited 232 children undergoing elective flexible bronchoscopy. Participants were grouped using a cough nature symptom‐based approach, into wet, dry or no cough groups. Broncho‐alveolar lavage (BAL) and clinical data, including presence, nature, and duration of cough and key demographic factors, were collected. Children with wet cough (n = 143) were more likely to have lower airway bacterial infection (OR 2.6, P = 0.001), viral infection (OR 2.04, P = 0.045) and viral–bacterial co‐infection (OR 2.65, P = 0.042) compared to those without wet cough. Wet cough was associated with heightened airway neutrophilia (median 19%) as compared to dry or no cough. Viral–bacterial co‐infection was associated with the highest median %neutrophils (33.5%) compared to bacteria only, virus/es only and no infection (20%, 18%, and 6%, respectively, P < 0.0001). Children with wet cough had higher rates of lower airway infection with bacteria and viruses. Maximal neutrophilic airway inflammation was seen in those with viral–bacterial co‐infection. Cough nature may be a useful indicator of infection and inflammation of the lower airways in children. Pediatr Pulmonol. 2014; 49:561–568. © 2013 Wiley Periodicals, Inc.