Malacia, inflammation and BAL culture in children with persistent respiratory symptoms

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, 24-hour oesophageal pH measurement and fiberoptic bronchoscopy (FOB) with bronchoalveolar lavage (BAL) were performed. BAL fluid (BALF) was processed for neutrophil counting and bacterial culture. Inflammation of the respiratory mucosa was registered.A structural abnormality of the central airways was found in 47% (40% females). In 19% neither anatomical anomalies nor inflamed respiratory mucosa were observed, whereas in 64% definite macroscopic mucosal inflammation was registered. Inflammation of the respiratory mucosa was associated with a significantly higher percentage of neutrophils in the BALF, 48% (IQR 14–82) compared to 7% (IQR 0–16) (p<0,025). A positive BALF culture was found in 62% of the infants with mucosal inflammation compared to 25% in the group without inflammation (p<0.016). Fifty six per cent 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 BAL fluid neutrophils were detected.

Jaar van publicatie:2011

Trefwoorden:BAL culture