Pediatric Bronchitis Differential Diagnoses

  • Author: Patrick L Carolan, MD; Chief Editor: Michael R Bye, MD   more...
 
Updated: Mar 29, 2011
 
 

Diagnostic Considerations

Consider the following in the diagnosis of bronchitis in pediatric patients:

  • Retained foreign body
  • Bronchopulmonary allergy
  • Immunosuppression

Chronic bronchitis is often part of an underlying disease process, such as asthma, cystic fibrosis, dyskinetic cilia syndrome, foreign body aspiration, or exposure to an airway irritant. Recurrent tracheobronchitis may also be seen in patients with tracheostomy or with certain forms of immunodeficiency. In all of these patient groups, chronic bronchitis should not be the primary diagnosis, because it does not describe the pathology of the underlying disorder.

Differentials

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Patrick L Carolan, MD  Adjunct Associate Professor, Departments of Pediatrics, Family Practice, and Community Health, University of Minnesota Medical School; Medical Director of Minnesota Sudden Infant Death Center; Attending Staff, Department of Emergency Services, Children's Hospitals and Clinics of Minnesota

Patrick L Carolan, MD is a member of the following medical societies: American Academy of Pediatrics and International Society of SIDS Researchers

Disclosure: Nothing to disclose.

Specialty Editor Board

Thomas Scanlin, MD  Chief, Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School

Thomas Scanlin, MD is a member of the following medical societies: American Association for the Advancement of Science, American Society for Biochemistry and Molecular Biology, American Thoracic Society, Society for Pediatric Research, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Charles Callahan, DO  Professor, Deputy Chief of Clinical Services, Walter Reed Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, and Christian Medical & Dental Society

Disclosure: Nothing to disclose.

Mary E Cataletto, MD  Associate Director, Division of Pediatric Pulmonology, Winthrop University Hospital; Professor of Clinical Pediatrics, State University of New York at Stony Brook; Director of Children's Sleep Services, Winthrop University Hospital

Mary E Cataletto, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Chest Physicians

Disclosure: Shering Plough Pharmaceuticals Honoraria Consulting

Chief Editor

Michael R Bye, MD  Professor of Clinical Pediatrics, Division of Pulmonary Medicine, Columbia University College of Physicians and Surgeons; Attending Physician, Pediatric Pulmonary Medicine, Morgan Stanley Children's Hospital of New York Presbyterian, Columbia University Medical Center

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, and American Thoracic Society

Disclosure: Nothing to disclose.

References

  1. Horner CC, Bacharier LB. Diagnosis and management of asthma in preschool and school-age children: focus on the 2007 NAEPP Guidelines. Curr Opin Pulm Med. Jan 2009;15(1):52-6. [Medline].

  2. Brodzinski H, Ruddy RM. Review of new and newly discovered respiratory tract viruses in children. Pediatr Emerg Care. May 2009;25(5):352-60; quiz 361-3. [Medline].

  3. Miron D, Srugo I, Kra-Oz Z, Keness Y, Wolf D, Amirav I, et al. Sole pathogen in acute bronchiolitis: is there a role for other organisms apart from respiratory syncytial virus?. Pediatr Infect Dis J. Jan 2010;29(1):e7-e10. [Medline].

  4. Voynow JA, Rubin BK. Mucins, mucus, and sputum. Chest. Feb 2009;135(2):505-12. [Medline].

  5. Mall MA. Role of cilia, mucus, and airway surface liquid in mucociliary dysfunction: lessons from mouse models. J Aerosol Med Pulm Drug Deliv. Mar 2008;21(1):13-24. [Medline].

  6. Kreindler JL, Jackson AD, Kemp PA, Bridges RJ, Danahay H. Inhibition of chloride secretion in human bronchial epithelial cells by cigarette smoke extract. Am J Physiol Lung Cell Mol Physiol. May 2005;288(5):L894-902. [Medline]. [Full Text].

  7. McConnell R, Berhane K, Gilliland F, Molitor J, Thomas D, Lurmann F, et al. Prospective study of air pollution and bronchitic symptoms in children with asthma. Am J Respir Crit Care Med. Oct 1 2003;168(7):790-7. [Medline]. [Full Text].

  8. Brieu N, Guyon G, Rodière M, Segondy M, Foulongne V. Human bocavirus infection in children with respiratory tract disease. Pediatr Infect Dis J. Nov 2008;27(11):969-73. [Medline].

  9. Schildgen O, Müller A, Allander T, Mackay IM, Völz S, Kupfer B, et al. Human bocavirus: passenger or pathogen in acute respiratory tract infections?. Clin Microbiol Rev. Apr 2008;21(2):291-304, table of contents. [Medline]. [Full Text].

  10. Allander T. Human bocavirus. J Clin Virol. Jan 2008;41(1):29-33. [Medline].

  11. [Best Evidence] Koehoorn M, Karr CJ, Demers PA, Lencar C, Tamburic L, Brauer M. Descriptive epidemiological features of bronchiolitis in a population-based cohort. Pediatrics. Dec 2008;122(6):1196-203. [Medline].

  12. Tsai CH, Huang JH, Hwang BF, Lee YL. Household environmental tobacco smoke and risks of asthma, wheeze and bronchitic symptoms among children in Taiwan. Respir Res. Jan 29 2010;11:11. [Medline]. [Full Text].

  13. Zaccagni HJ, Kirchner L, Brownlee J, Bloom K. A case of plastic bronchitis presenting 9 years after Fontan. Pediatr Cardiol. Jan 2008;29(1):157-9. [Medline].

  14. Zahorec M, Kovacikova L, Martanovic P, Skrak P, Kunovsky P. The use of high-frequency jet ventilation for removal of obstructing casts in patients with plastic bronchitis. Pediatr Crit Care Med. May 2009;10(3):e34-6. [Medline].

  15. Shah SS, Drinkwater DC, Christian KG. Plastic bronchitis: is thoracic duct ligation a real surgical option?. Ann Thorac Surg. Jun 2006;81(6):2281-3. [Medline].

  16. US Department of Health and Human Services. Vital and Health Statistics. National Ambulatory Medical Care Survey: 1991 Summary. Series 13: Data from the National Health Survey No. 116. DHHS Publication; May 1994.

  17. Weigl JA, Puppe W, Belke O, Neusüss J, Bagci F, Schmitt HJ. The descriptive epidemiology of severe lower respiratory tract infections in children in Kiel, Germany. Klin Padiatr. Sep-Oct 2005;217(5):259-67. [Medline].

  18. Brunton S, Carmichael BP, Colgan R, Feeney AS, Fendrick AM, Quintiliani R, et al. Acute exacerbation of chronic bronchitis: a primary care consensus guideline. Am J Manag Care. Oct 2004;10(10):689-96. [Medline].

  19. Stiehm ER. The four most common pediatric immunodeficiencies. J Immunotoxicol. Apr 2008;5(2):227-34. [Medline].

  20. Ozkan H, Atlihan F, Genel F, Targan S, Gunvar T. IgA and/or IgG subclass deficiency in children with recurrent respiratory infections and its relationship with chronic pulmonary damage. J Investig Allergol Clin Immunol. 2005;15(1):69-74. [Medline].

  21. Kainulainen L, Nikoskelainen J, Ruuskanen O. Diagnostic findings in 95 Finnish patients with common variable immunodeficiency. J Clin Immunol. Mar 2001;21(2):145-9. [Medline].

  22. Kamin W, Maydannik VG, Malek FA, Kieser M. Efficacy and tolerability of EPs 7630 in patients (aged 6-18 years old) with acute bronchitis. Acta Paediatr. Apr 2010;99(4):537-43. [Medline]. [Full Text].

  23. Kamin W, Maydannik V, Malek FA, Kieser M. Efficacy and tolerability of EPs 7630 in children and adolescents with acute bronchitis - a randomized, double-blind, placebo-controlled multicenter trial with a herbal drug preparation from Pelargonium sidoides roots. Int J Clin Pharmacol Ther. Mar 2010;48(3):184-91. [Medline].

 
Previous
Next
 
Normal airway color and architecture (in a child with mild tracheomalacia).
Airway of a child with chronic bronchitis shows erythema, loss of normal architecture, and swelling.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.