Protracted Bacterial Bronchitis in children- shedding light on lingering cough

Abstract

Protracted Bacterial Bronchitis [PBB] in children, as the name suggests, is a prolonged wet cough of bronchial origin for more than four weeks. The affected children will be otherwise hale and healthy except for the disturbing diurnal cough. Unlike asthma, the cough is characteristically wet or productive, and there is no specific nocturnal variation of symptoms. It usually affects preschool children. The diagnosis is clinical in experienced hands without going in for an extensive workup. Responding to the treatment is one of the criteria to diagnose PBB as per consensus guidelines. Most patients respond to appropriate antibiotic therapy of 2-4 weeks duration, usually amoxicillin-clavulanate. Few children may go in for recurrence of symptoms; in such cases, bronchoscopic workup of the airway is warranted. Thus, clinicians should always have a high index of suspicion of this condition in otherwise healthy young children who have a chronic wet cough of more than four weeks duration. Timely management of such cases would prevent the development of chronic suppurative lung disease and long-term morbidity.