Evrim HEPKAYA, Pelin GÜLER
Trends in Pediatrics - 2026;7(1):71-76
Background: Protracted bacterial bronchitis (PBB) is an increasingly recognized cause of chronic wet cough in children and may lead to bronchiectasis if not adequately treated. However, data regarding its clinical presentation and associated risk factors remain limited. Objective: To evaluate the clinical, radiological, and microbiological characteristics of children diagnosed with PBB and to identify factors associated with disease severity and recurrence. Methods: This cross-sectional study included 49 children followed in a pediatric pulmonology clinic with a diagnosis of PBB. Demographic features, comorbidities, sputum microbiology, pulmonary function tests, thoracic computed tomography (CT) findings, and serum vitamin D levels were analyzed. The association between clinical parameters and annual bronchitis frequency was evaluated using correlation analyses. Results: Forty-nine children were analyzed (69.3% female), with a median age of 7 years. Asthma and atopy were present in 65.3% and 30.6% of patients, respectively. A pathogen was isolated in 63.3% of sputum samples, with Haemophilus influenzae being the most common agent (41.9%). A moderate inverse correlation was detected between serum vitamin D levels and the annual number of bronchitis episodes (rho = -0.56; p = 0.0016). Spirometry values were mostly within normal limits; however, weak inverse correlations were observed between pulmonary function parameters and exacerbation frequency. Thoracic CT abnormalities were identified in 81.9% of patients, most commonly bronchial wall thickening. Conclusion: PBB is frequently accompanied by asthma and recurrent infections. H. influenzae appears to be associated with increased disease burden. Low vitamin D levels may contribute to higher susceptibility to recurrent bronchitis. Early diagnosis and targeted microbiological evaluation are essential to prevent long-term pulmonary complications.
