Non-Cystic Fibrosis-Related Bronchiectasis in Children: Are Bacteria Always to Blame?

Abstract

Background: Bronchiectasis isa structural alteration characterized by the dilation of bronchial walls due to inflammation, resulting in a loss of elasticity and muscle function. They are more common in adults than children and have various etiologies (such as chronic infections, particularly in developing countries, or immunodeficiencies in industrialized nations), with up to 40% being idiopathic. Case presentation: We reported the case of a nine-year-old child who, following two lower respiratory tract infections (a severe H1N1 influenza pneumonia and a milder episode caused by M. pneumoniae), developed bronchiectasis without underlying predisposing conditions. Discussion: Bronchiectasis is a morphological alteration of the bronchi, which can develop subsequently to lung infections and may remain clinically silent even for a long time. The most common associated symptoms include productive cough, persistent rales, therapy-resistant “asthma,” and recurrent lung infections. High-Resolution CT (HRCT) scans are the gold standard for their diagnosis, while their management requires a comprehensive approach, including pharmacological and psychosocial measures. It is always advisable to investigate the underlying etiology to eventually establish a causal treatment. Conclusion: This study aims to emphasize that not only bacteria but also viral infections and their associated inflammatory impact on lung tissue can contribute to the development of bronchiectasis. This study aims to implement current knowledge regarding non-cystic fibrosis-related bronchiectasis and to underscore the significance of post-acute instrumental reassessment in lower respiratory tract infections, especially when severe.