Evaluation of Patients with Chronic Cough Referred to Pediatric Pulmonology Outpatient Clinic

Öz

Objective: A cough that lasts longer than four weeks in children is called chronic cough. The aim of this study is to determine the underlying causes of chronic cough.

Material and Methods: Patients aged 0-18 years who were referred to Şanlıurfa Training and Research Hospital pediatric pulmonology outpatient clinic between 27 December 2021 and 30 June 2022 due to chronic cough were enrolled. Patients with known cystic fibrosis, primary ciliary dyskinesia, interstitial lung disease, asthma, bronchopulmonary dysplasia were excluded from the study. The “CHEST Guideline and Expert Panel Report” guideline was used in the approach to chronic cough.

Results: 153 patients were included in this study. The most common causes of chronic cough were asthma (30.7%), protracted bacterial bronchitis (20.3%), and upper respiratory tract cough syndrome (11.1%). Wet cough was present in 60.8% of the patients with chronic cough and the most common diagnosis in patients with wet cough were protracted bacterial bronchitis (33.3%), pneumonia and other lung infections (17.2%) and bronchiectasis (12.9%). The most common diagnoses were asthma (68.3%), upper airway cough syndrome (6.7%), and natural recovery (6.7%) in patients with dry cough. Failure to thrive was more common in patients with wet cough than patients with dry cough (p<0.030) and fever, weight loss and desaturation were only present in patients with wet cough.

Conclusion: The most common reasons are asthma, protracted bacterial bronchitis and upper airway cough syndrome. The differential diagnosis should be made by pediatricians based on specific cough pointers, careful physical examination and tests performed in line with the recommendations of the guidelines.

Anahtar Kelimeler

• asthma
• child
• chronic cough
• pneumonia
• Broncitis

Kronik Öksürük Şikayeti ile Çocuk Göğüs Hastalıkları Polikliniğine Başvuran Hastaların Değerlendirilmesi

Öz

Amaç: Çocuklarda dört haftadan uzun süren öksürük kronik öksürük olarak adlandırılmaktadır. Bu çalışmada kronik öksürüğün altta yatan nedenlerinin saptanması amaçlandı.

Gereç ve Yöntemler: Bu çalışmaya kronik öksürük nedeniyle 27 Aralık 2021- 30 Haziran 2022 tarihleri arasında Şanlıurfa Eğitim ve Araştırma Hastanesi Çocuk Göğüs Hastalıkları Polikliniğine başvuran 0-18 yaş arası hastalar dahil edildi.Bilinen kistik fibrozis, primer silyer diskinezi, interstisyel akciğer hastalığı, astım, bronkopulmoner displazi tanısı olan hastalar çalışma dışı bırakıldı. Kronik öksürüğe yaklaşımda “CHEST Guideline and Expert Panel Report” kılavuzu örnek alındı.

Bulgular: Çalışmaya 153 hasta dahil edildi. Bu çalışmada kronik öksürüğün en sık nedenleri astım (%30.7), uzamış bakteriyel bronşit (%20.3), üst solunum yolu öksürük sendromu (%11.1) olarak sıralandı. Kronik öksürük olan hastaların %60.8’inde ıslak öksürüğün mevcut olduğu, ıslak öksürüğü olan hastalarda ise en sık tanıların uzamış bakteriyelbronşit (%33.3), pnömoni ve diğer akciğer enfeksiyonları (tüberküloz ve kist hidatik) (%17.2) ve bronşektazi (%12.9) olduğu görüldü. Kuru öksürüğü olan hastalarda ise en sık tanılar astım (%68.3), üst solunum yolu öksürük sendromu (%6.7) ve doğal iyileşme (%6.7) olarak sıralandı. Islak öksürük olan hastalarda kilo alamama şikayeti kuru öksürük olan hastalara göre daha belirgin iken (p<0.030) ateş, kilo kaybı ve desaturasyon sadece ıslak öksürük olan hastalarda mevcuttu.

Sonuç: Kronik öksürüğün en sık nedenleri astım, uzamış bakteriyel bronşit, üst solunum yolu öksürük sendromudur. Kronik öksürüğü olan hastalarda dikkatli fizik muayene ve rehberlerin önerileri doğrultusunda yapılan tetkikler ile hastalara tanı konulup tedavi kararı verilmelidir.

Anahtar Kelimeler

• astım
• çocuk
• kronik öksürük
• pnömoni
• Bronşit

Kaynakça

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