Children with chronic wet cough and without cystic fibrosis (non-CF) may suffer from chronic suppurative lung disease (CSLD) or bronchiectasis. Pseudomonas aeruginosa (Pa) can be one of the offending microbes in these children. The present study aimed to describe the clinical course of children with the above two conditions who were infected with Pa. Data of 54 children with CSLD/bronchiectasis who were diagnosed and attended in our department were retrospectively analysed through a Cox proportional hazard model, with age, presence of bronchiectasis, use of inhaled colistin, azithromycin, inhaled hypertonic saline as the covariates. In 42 of the 54 patients, there was no identifiable cause or underlying chronic disorder. Microbiological clearance was defined as the absence of daily wet cough for four months along with four negative cultures taken during the last four consecutive follow-up visits. Multivariate analysis was performed with a Cox proportional hazard model with time to microbiological clearance as the outcome. Results are described as Hazard Ratios (HR) with 95% Confidence Intervals (95%CI). Nebulised antibiotics and the presence of bronchiectasis were statistically significant predictors of remission (HR: 3.99; 95%CI: 1.12–14.14; p = 0.032, and HR: 0.24; 95%CI: 0.08–0.71; p = 0.010). In conclusion, the rate of microbiological clearance increases with the use of inhaled colistin and decreases when there is established bronchiectasis.

Children with chronic wet cough and without cystic fibrosis (non-CF) may suffer from chronic suppurative lung disease (CSLD) or bronchiectasis. Pseudomonas aeruginosa (Pa) can be one of the offending microbes in these children. The present study aimed to describe the clinical course of children with the above two conditions who were infected with Pa.

Introduction: Lung involvement in pediatric rheumatic diseases significantly impacts morbidity and mortality. High-resolution computed tomography (HRCT) is a sensitive diagnostic tool for detecting lung involvement; however, it raises concerns regarding radiation exposure. Spirometry, a non-invasive and widely accessible test, is often used to assess pulmonary function, but its accuracy in identifying lung disease in children with newly diagnosed rheumatic conditions remains uncertain. This study evaluates the reliability of spirometry, using HRCT as the reference standard, in detecting early lung involvement in this population. Methods: At our institution, all patients suspected of having lung involvement—either due to respiratory symptoms or the high prevalence of respiratory involvement associated with their specific disease—underwent an HRCT scan and pulmonary assessment. A retrospective review of HRCT scans was conducted for 22 pediatric patients diagnosed with rheumatic disease between January 2021 and December 2023, all of whom exhibited pathological findings in their HRCT scans. HRCT scans were conducted with a paired end-inspiratory and forced-expiratory protocol using 1-mm collimation. Radiological findings, including parenchymal opacities, ground-glass opacities (GGOs), reticular patterns, honeycombing, parenchymal bands, bronchiectasis, peribronchial wall thickening, and air trapping were assessed. Spirometric values, including percent predicted values for Forced Expiratory Volume in 1 second (ppFEV1), Forced Vital Capacity (ppFVC), and the FEV1/FVC ratio, were collected for all patients who had an acceptable flow-volume curve Results: Of the 22 patients enrolled, 17 (77.3%) had technically acceptable spirometry results. Using HRCT as the reference standard, spirometry yielded a sensitivity of 29.4%. Conclusion: Although spirometry demonstrated excellent positive predictive value, its low sensitivity indicates that it may miss early lung involvement in children with newly diagnosed rheumatic diseases. These findings reinforce HRCT as the preferred diagnostic tool in this population, despite concerns about radiation exposure, to ensure accurate detection and management of lung involvement.