Serial high-resolution computed tomography (HRCT) in children with chronic productive cough and bronchiectasis unrelated to cystic fibrosis: correlations with clinical evaluation

Objectives. To follow prospectively for 3 years children with chronic productive cough and non-Cystic Fibrosis bronchiectasis defined by high resolution computed tomographic scanning, in order to determine the evolution of lung damage; to compare their computed tomography scores with the results obtained with a simple clinical parameter (cough index) used to monitor the disease. Methods. We studied 22 children for 3 years, during which they underwent regular physiotherapy and antibiotic therapy for acute lower respiratory tract infections. The number of months/year of productive cough (cough index) was calculated for each patient for the 2 years before study entry and during the study. At the end of follow-up, chest high resolution computed tomographic (HRCT) was repeated. Results. During follow-up the cough index improved or remained stable in 19 children (86%); among these, HRCT scores decreased in 12, remained stable in 6 and worsened in 1. Mild and moderate bronchiectasis remained unchanged in 17 patients (77%) and completely resolved in 4. There was a close correlation between the change in cough index before and during the follow-up, and the change in HRCT scores (r = 0.66; p = 0.0008). Conclusion. The cough index significantly improved and the HRCT score of most patients improved or remained unchanged during the 3 years of systematic treatment; there was a close correlation between the change in the HRCT scores and the change in the cough index used to monitor the evolution of lung damage. Patients with a persistent productive cough do not need to repeat HRCT within a short time if the clinical symptoms improve or remain stable.