Patient education: Bronchiectasis in children (The Basics)

What is bronchiectasis? — Bronchiectasis is a lung condition that causes a long-lasting cough, and sometimes shortness of breath and other symptoms. In people with this condition, the airways (the branching tubes that carry air within the lungs) are wider than normal (figure 1). This leads to an increase in mucus, which can be hard to cough up. When mucus stays in the lungs, people are more likely to get lung infections or bronchitis.

The most common causes of bronchiectasis in children include:

●Cystic fibrosis – This is a disease that some children are born with. It makes thick mucus build up and clog the lungs and other parts of the body (figure 2).

●Other diseases a child is born with – These include lung problems or diseases that make it hard to fight infections.

●A piece of food or another object stuck in the airway

●A long-lasting lung infection, such as certain types of bronchitis or pneumonia

What are the symptoms of bronchiectasis in children? — The most common symptoms are:

●A long-lasting cough – The cough usually brings up thick, sticky mucus (sounds "wet"). It can last weeks or even months.

●Frequent pneumonia or other lung infections – Your child might have:

•Fever

•Chest pain that gets worse when they take a breath

•Trouble breathing or breathing that sounds like whistling (wheezing)

A child with bronchiectasis might also:

●Get tired or short of breath during exercise or play

●Sinus infections – The sinuses are hollow areas in the bones of the face (figure 3). Sinus infections can cause a stuffy nose, pain in the cheeks or forehead, and yellow or green mucus from the nose.

●Cough up blood, or have skin or lips that look blue– These symptoms are not common, but do happen in a few children with bronchiectasis.

Should my child see a doctor or nurse? – Yes. Call a doctor or nurse if your child:

●Has a cough for more than 2 weeks

●Gets a cough after choking on food or another object, even if it happened several days or weeks ago

●Coughs up thick, dark yellow or green mucus, or thick, sticky mucus every day

●Coughs up blood

●Has trouble breathing (figure 4)

●Has a fever

Will my child need tests? — Maybe. The doctor or nurse will do an exam and learn about your child's symptoms. Your child might have some or all of these tests:

●A chest X-ray

●A CT scan of the chest – A CT scan is an imaging test that creates pictures of the inside of the body. It can show a detailed picture of your lungs and airways. A CT scan is usually needed to know if a person has bronchiectasis, and to see which parts of the lungs are involved.

●A "sweat test" – During this test, a doctor collects a small amount of sweat from a person's arm and measures the amount of salt in it. This is a test for cystic fibrosis.

●Blood tests – To look for cystic fibrosis, problems with the body's infection-fighting system (called the "immune system"), and other problems.

●A test called a "bronchoscopy" – During this test, a doctor uses a thin tube (called a "bronchoscope") to look at the airways inside the lungs. It can help find an object stuck in the airway or take samples of mucus from the lungs.

●Tests to learn how well your child's lungs are working ("pulmonary function tests")

●Tests to check for swallowing problems

How is bronchiectasis in children treated? — Treatments can include:

●Removal of anything stuck in the airway

●Medicines – These can include:

•Antibiotic medicines to help treat or prevent infections

•Medicines to thin out mucus or moisten the airways (for children with cystic fibrosis)

•Medicines to help open up the airways or reduce inflammation

●Airway clearance therapy – This involves loosening the mucus in the lungs so your child can cough it up more easily. It is sometimes called "chest physiotherapy." Your child's doctor, nurse, or therapist can show you different ways to do this.

●Surgery – In some cases, removing part of a lung will help stop symptoms or infections.

Is there anything I can do to help my child? — Yes. You can:

●Keep your home and car smoke-free and keep your child away from smoke in other places.

●Make sure your child gets all his or her vaccines, including the pneumonia vaccine and the flu vaccine.

●Help your child get the nutrients they need. This can help lungs work better.

●Get treatment right away if your child gets an infection. This can help prevent worse problems.

More on this topic

Patient education: Aspiration pneumonia (The Basics)
Patient education: Cough in children (The Basics)
Patient education: Coughing up blood (The Basics)
Patient education: Cystic fibrosis (The Basics)
Patient education: Secondhand smoke: Risks to children (The Basics)

Patient education: Asthma symptoms and diagnosis in children (Beyond the Basics)
Patient education: Flexible bronchoscopy (Beyond the Basics)