Feuchter Husten und protrahierte bakterielle Bronchitis bei Kindern und Jugendlichen

Rose, M. A.

Persistent cough is one of the most common reasons patients present to outpatient practices. Especially in children, chronic cough (>4 weeks) is a significant burden on the child and family. While in the past, the lower airways were considered sterile, the concept of a physiologic microbiome of the lower respiratory tract has increasingly emerged. Of the differential diagnoses of chronic cough, protracted bacterial bronchitis (PBB) is more common in otherwise (pulmonary) healthy children under 6 years of age. Tracheomalacia may primarily exist or be the result of mechanically straining coughing, whereas apart from a reduced alveolar phagocytosis, there is usually no systemic or local immune weakness. Instead, an activated innate immunity with increased gene expression of the interleukin-1β signaling pathway can be immunologically detected. Here too, it is difficult to differentiate between cause and effect of chronic inflammatory events. Today, PBB and non-CF bronchiectasis, i.e., bronchiectasis not caused by cystic fibrosis (CF), are two sides of a disease spectrum of suppurative lung diseases, thus, making consequent therapy and long-term pediatric pneumological support of children with chronic productive cough necessary.