Bronchiectasis in children

Date Published:

Wednesday, May 13, 2020

Duration:

21:37

Associate Professor Cass Byrnes discusses the chronic wet cough in a child, including equity issues, clinical presentations and investigations.

Topics:

History; what is important to ask?
Simple way to categorise cough in a child.
Are there specific tests we need to order?
Does being immunised help a child?
What referral needs to be marked as urgent?
Practical management strategies.
What is the prognosis for a child like Joseph?

Case study

Joseph is a 6 year old Samoan boy who lives in South Auckland and is the youngest of 5 children. He is mostly cared for by his grandmother Rosa as his parents work long hours. Joseph had repeated coughs and colds throughout winter last year and also spent time in hospital with pneumonia.

Rosa, who is a heavy smoker, brings him to you today and tells you: "He’s not like my other grandkids - he’s often sick with coughing, coughing phlegm and he can't keep up with the rest of the kids."

Take home messages

Investigate a child with a frequent wet or productive sounding cough.
Look for other risk factors.
Low bar for referral.
Address environmental insults if you are able.

Resources

Toward making inroads in reducing the disparity of lung health in Australian indigenous and New Zealand Māori children Front Pediatr. 2015
Chronic Suppurative Lung Disease and Bronchiectasis in Children and Adults in Australia and New Zealand Thoracic Society of Australia and New Zealand Guidelines Med J Aust. (2015)
Chronic wet cough: Protracted bronchitis, chronic suppurative lung disease and bronchiectasis Pediatric Pulmonology (2008)
Preventing and managing bronchiectasis in high-risk paediatric populations bpac^_nz (2020)

Presenter

Associate Professor Cass Byrnes
Respiratory Paediatrician

Catherine (Cass) Byrnes is an Associate Professor in the Paediatric Department of the University of Auckland and a Paediatric Respiratory Specialist at Starship Children's Health.
After graduating from the School of Medicine at the University of Auckland, she undertook paediatric training initially in New Zealand then in the United Kingdom, ultimately training in paediatric respiratory medicine at the Royal Brompton Hospital, National Heart and Lung Institute, London. On returning to New Zealand as a Paediatric Respiratory Specialist she developed a number of national services including an extensive respiratory outreach programme.

Currently she leads care for children and youth with bronchiectasis and cystic fibrosis. Cass has an especial interest in improving equity of healthcare and outcomes for children of Māori and Pacific ethnicity. Her major streams of research are in the prevention of the development of chronic lung disease following early lower respiratory tract infections and the prevention of disease progression in bronchiectasis and cystic fibrosis. To this end she has developed a number of international collaborations enrolling nationally with findings translated into evidence-based care.

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