Prevalence of symptoms and signs related to bronchiectasis in children

	Frequency among children with bronchiectasis^[1]	Comments	Odds ratio for predicting bronchiectasis*^[2] (95% CI)
Symptom
Chronic wet or productive cough	Very common	Present in up to 50% of children with bronchiectasis in resource-rich settings and up to 100% in resource-limited settings or certain indigenous populations	527 (45.4-6102)
Recurrent protracted bacterial bronchitis	Unknown (but probably somewhat common)	Diagnosis is made based on clinical criteria; management requires follow-up through resolution	18.4 (1.0-349.7)
Recurrent or previous pneumonia	Very common	Particularly common in low-resource populations (up to 100% of cohort)	22.8 (1.2-424.3)
Wheeze or reversible airway obstruction	Common (10 to 66%)	Likely differs from classic asthma; manage based on clinical response to therapy
Hemoptysis	Uncommon	Suggests advanced disease
Chest pain	Uncommon	Symptom is typically intermittent rather than chronic
Dyspnea/exertional dyspnea	Highly variable among different populations	Common in low-resource settings or when diagnosis is delayed in more severe disease	4.3 (0.2-109.7)
Sinusitis/otitis problems	Highly variable among different populations	Often associated with underlying immunodeficiency^¶^[3]
Faltering growth	Uncommon	Common in low-resource settings or when diagnosis is delayed
Feeding difficulties	Uncommon	Suggests possibility of recurrent small-volume aspiration	22.8 (1.2-424.3)
Signs
Digital clubbing	Highly variable among different populations	Uncommon in resource-rich settings, but found in up to 70% of children in low-resource settings or when diagnosis is delayed	7.5 (0.3-161.5)
Chest deformity	Common (15 to 30%)	Includes hyperinflation, Harrison sulci, pectus carinatum	4.3 (0.2-109.7)
Differential airway sounds (on chest auscultation)	Unknown	More likely with focal disease or during an exacerbation	7.5 (0.3-161.5)
Crackles	Uncommon	More common prior to antibiotic treatment, during an exacerbation, when disease is severe, or in patients with certain underlying diseases such as bronchiolitis obliterans	10.8 (0.5-218.9)
Basic tests
Chest radiograph abnormal	Uncommon	Low sensitivity to detect bronchiectasis	41.6 (2.3-750)
FEV₁ percent predicted (median)	52 to 95%	Median FEV₁ is lower in resource-limited settings or when diagnosis is delayed	4.3 (0.2-109.7)
FVC percent predicted (median)	58 to 96%	Median FVC is lower in resource-limited settings or when diagnosis is delayed	Not stated

Bold text indicates strongest predictors of bronchiectasis compared with self-limited cough*.

FEV₁: forced expiratory volume in 1 second; FVC: forced vital capacity.
* For each symptom/sign, the odds ratio of having bronchiectasis is compared with children whose cough resolved without any specific treatment, based on a study involving 326 Australian children with chronic cough newly referred to a respiratory pediatrician^[2].
¶ In a study from Turkey, otitis/sinusitis was present in 64% of children with bronchiectasis. The high prevalence of otitis/sinusitis in this study is from a population in Turkey with very high rates of consanguinity (present in 59.4% of children with bronchiectasis)^[3] and associated risk of rare primary immunodeficiency disorders.

References:

Chang AB, Bush A, Grimwood K. Bronchiectasis in children: Diagnosis and Treatment. Lancet 2018; 392:866.
Chang AB, Robertson CF, van Asperen PP, et al. Children with chronic cough: when is watchful waiting appropriate? Development of likelihood ratios for assessing children with chronic cough. Chest 2015; 147:745.
Satirer O, Mete YA, Emiralioglu N, et al. A review of the etiology and clinical presentation of non-cystic fibrosis bronchiectasis: A tertiary care experience. Respir Med 2018; 137:35.

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Prevalence of symptoms and signs related to bronchiectasis in children