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Bronchoscopy contributes to the clinical management of Indigenous children newly diagnosed with bronchiectasis

Pizzutto, Susan J., Grimwood, Keith, Bauert, Paul, Schutz, Kobi L., Yerkovich, Stephanie T., Upham, John and Chang, Anne B. (2013). Bronchoscopy contributes to the clinical management of Indigenous children newly diagnosed with bronchiectasis. Pediatric Pulmonology,48(1):67-73.

Document type: Journal Article
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Title Bronchoscopy contributes to the clinical management of Indigenous children newly diagnosed with bronchiectasis
Author Pizzutto, Susan J.
Grimwood, Keith
Bauert, Paul
Schutz, Kobi L.
Yerkovich, Stephanie T.
Upham, John
Chang, Anne B.
Journal Name Pediatric Pulmonology
Publication Date 2013
Volume Number 48
Issue Number 1
ISSN 8755-6863   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84872845171
Start Page 67
End Page 73
Total Pages 7
Place of Publication United States
Publisher John Wiley & Sons, Inc.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Some pediatric centers perform flexible bronchoscopy (FB) routinely when bronchiectasis is suspected. However, there are no published data evaluating this practice.


To evaluate the contribution of FB and bronchoalveolar lavage (BAL) to the initial management of children newly diagnosed with non-cystic fibrosis (CF) bronchiectasis.


We examined FB and BAL data collected prospectively in 56 children aged 0.8–9.8 years during initial investigations for bronchiectasis. Investigations contributed to management if any of the following were identified: (1) airway obstruction requiring additional intervention, (2) lower airway eosinophilia (BAL eosinophils >2.5%), or (3) BAL fluid culture >104 colony-forming units/ml of a respiratory bacterial pathogen requiring change from usual empiric antibiotics.


Of the 56 children undergoing FB, there were 25 occasions in 23 children where these procedures altered empiric treatment. Lower airway eosinophilia was identified in 19 (34%) children, BAL microbiology results led to antibiotic changes in 5 (9%) and an unsuspected foreign body was found in another (2%). Strongyloides serology was performed in 38 children, including 12 of the 19 with airway eosinophilia, and was positive in 5 of these 12 children (42%).


Contrary to some expert recommendations that FB should only be performed when bronchiectasis is localized, our data suggest that FB with BAL should at least be included in the initial investigations of Indigenous children with non-CF bronchiectasis.
Keywords chronic suppurative lung disease
foreign body
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