Chronisch produktiver Husten im Kindesalter

A. Irnstetter; M. Griese; M. Kappler

doi:10.1055/s-0038-1629354

Kinder- und Jugendmedizin, Table of Contents

Kinder- und Jugendmedizin 2013; 13(05): 335-341
DOI: 10.1055/s-0038-1629354

Husten

Schattauer GmbH

Chronisch produktiver Husten im Kindesalter

Die persistierende bakterielle Bronchitis (PBB) als häufigste UrsacheChronic wet cough in childrenProtracted bacterial bronchitis (PBB) as the most common cause

A. Irnstetter

¹Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, LMU München

,

M. Griese

¹Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, LMU München

,

M. Kappler

¹Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, LMU München

› Author Affiliations

Abstract

Zusammenfassung

Die persistierende bakterielle Bronchitis (PBB) stellt eine der häufigsten Ursachen von chronisch produktivem Husten im Kindesalter dar.

Neben anderen Ursachen führen insbesondere rezidivierende virale Infektionen und Nikotinexposition zu einer gestörten mukoziliären Clearance, welche die Besiedlung der unteren Atemwege mit pathogenen Keimen, wie z. B. S. pneumoniae, H. influenzae und Moraxella catarrhalis begünstigt. Dies führt zu einer Aktivierung des angeborenen Immunsystems und induziert eine chronische endobronchiale neutrophile Inflammation. Lang-fristig drohen die Entstehung einer chronisch suppurativen Lungenerkrankung (CSLD) und die Ausbildung von Bronchiektasen. Nach Ausschluss anderer spezifischer Ursachen von chronischem Husten wird die Diagnose anhand der typischen klinischen Symptomatik und des Sistierens des Hustens unter einem prolongierten antibiotischen Behandlungszyklus sowie begleitender Inhalationsund Physiotherapie gestellt.

Summary

Protracted bacterial bronchitis (PBB) is one of the most common causes of chronic productive cough in childhood. Recurrent viral infections and nicotine exposure among other causes lead to impaired mucociliary clearance and colonization of the lower respiratory tract with particular bacteria, such as S. pneumoniae, H. influenzae, and Moraxella catarrhalis. These persistent pathogens activate the innate immune system and induce a chronic neutrophilic endobronchial inflammation. If ongoing, development of chronic suppurative lung disease (CSLD) and bronchiectasis is possible. After exclusion of other specific causes of chronic cough, the diagnosis is made on the basis of typical clinical symptoms and resolution of cough under a prolonged cycle of oral antibiotic therapy and appropriate inhalation therapy and physiotherapy.

Schlüsselwörter

Chronisch produktiver Husten - mukoziliäre Clearance - protrahierte bakterielle Bronchitis - neutrophile Inflammation

Keywords

Chronic wet cough - mucociliary clearance - protracted bacterial bronchitis - neutrophilic inflammation

Full Text

References

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