# Pediatric Non-cystic Fibrosis Bronchiectasis in a Portuguese Tertiary Care Center: A Cross-Sectional Observational Study

## TL;DR

This study describes the clinical features and causes of bronchiectasis in children in Portugal, emphasizing the importance of early diagnosis.

## Contribution

The study provides new national data on pediatric non-cystic fibrosis bronchiectasis in Portugal, highlighting clinical and microbiological characteristics.

## Key findings

- Most patients had an identifiable cause, primarily postinfectious bronchiectasis or primary ciliary dyskinesia.
- Haemophilus influenzae and Streptococcus pneumoniae were the most common microorganisms found in respiratory samples.
- Multilobar lung involvement was common, with a mixed obstructive-restrictive lung pattern observed in a third of patients.

## Abstract

Introduction

Non-cystic fibrosis bronchiectasis (bronchiectasis) is an increasingly recognized but understudied disease in children. National data on this disease are scarce. This study aimed to describe the clinical, radiological, and microbiological characteristics of Portuguese children with bronchiectasis.

Methods

A retrospective observational study was conducted at a tertiary pediatric pulmonology center in northern Portugal. Pediatric patients diagnosed with bronchiectasis and followed between July 2020 and September 2023 were included.

Results

A total of 38 patients were included, of whom 19 (50.0%) were male, with a median age at diagnosis of 6.3 years (3.8-11.0 years). Recurrent wheezing (n = 30, 78.9%) and chronic wet cough (n = 18, 47.4%) were the most common symptoms. An underlying etiology was identified in 36 (94.7%) patients, primarily postinfectious bronchiectasis (n = 18, 47.4%) and primary ciliary dyskinesia (n = 10, 26.3%). Multilobar involvement was observed in 25 (65.8%) patients, most frequently affecting the middle and lower lobes. Spirometry showed a mixed obstructive-restrictive pattern in 10 (33.3%) patients and a predominantly obstructive pattern in nine (30.0%) patients. Haemophilus influenzae and Streptococcus pneumoniae were the most frequently isolated microorganisms, both in bronchoalveolar lavage and sputum cultures. Pseudomonas aeruginosa was detected in nine (7.4%) sputum samples.

Conclusion

This study highlights the diverse clinical presentations, etiologies, and microbiological findings in pediatric bronchiectasis. Identifiable causes were present in most cases, emphasizing the importance of clinical vigilance for early diagnosis and intervention. Further research is warranted to explore long-term outcomes and refine treatment approaches based on microbiological profiles.