Validity of flexible bronchoscopy in the diagnosis of chronic cough in children attending Assiut university children hospital

Context
Chronic cough in children is a major health problem with an increased prevalence from 8 to 20.78% between 1999 and 2016. Flexible bronchoscope has become one of the most valuable tools in the diagnostic workup of unexplained chronic cough in children.


Aims
To assess the children with chronic cough using flexible bronchoscopy in order to diagnose the underlying causes that remain otherwise unexplained by noninvasive diagnostic tests.


Settings and design
Observational cohort study.


Patients and methods
Children with unexplained chronic cough underwent flexible bronchoscopy during the period from October 2017 to December 2019. Bronchoalveolar lavage (BAL) was done for cytologic examination and microbiologic studies.


Results
This study involved 60 children, aged from 2 months to 14 years. Flexible bronchoscopy demonstrated positive findings in 65% of cases. The most common finding was congenital airway anomalies in 25% of cases. The second most common finding was visible bronchitis in 21.67% of cases. Other bronchoscopic findings included endobronchial mucous plug (5%), foreign body aspiration (6.67%), extrinsic compression on the airways (10%), and adenoid hypertrophy (1.66%). Cytologic examination of BAL fluid showed that neutrophilia was the most common finding. Haemophilus influenzae was the most common isolated organism in the BAL fluid samples.


Conclusions
Flexible bronchoscopy is a valuable safe tool in the diagnosis of chronic cough in children. BAL helped in the diagnosis of the underlying etiology by providing samples for cytologic and microbiologic studies.