open access

Vol 88, No 5 (2020)
Research paper
Submitted: 2020-05-20
Accepted: 2020-07-22
Published online: 2020-10-24
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The role of bronchoscopy in diagnosis of chronic cough in adults: a retrospective single-center study

Patryk A Sobczak1, Justyna M Sobczak1, Sebastian Majewski1, Joanna Miłkowska-Dymanowska1, Zofia Kurmanowska2, Karolina Szewczyk2, Ewa Tyczkowska-Sieroń3, Adam J Białas2, Adam Antczak4, Paweł Górski1, Wojciech J Piotrowski1
DOI: 10.5603/ARM.a2020.0140
·
Pubmed: 33169812
·
Adv Respir Med 2020;88(5):406-411.
Affiliations
  1. Department of Pneumology and Allergy, 1st Chair of Internal Medicine, Medical University of Lodz, Lodz, Poland
  2. Department of Pathobiology, 1st Chair of Internal Medicine, Medical University of Lodz, Lodz, Poland
  3. Department of Biology and Parasitology, 1st Chair of Biology and Medical Microbiology, Medical University of Lodz, Lodz, Poland
  4. Department of General and Oncological Pneumonology, 1st Chair of Internal Diseases, Medical University of Lodz, Lodz, Poland

open access

Vol 88, No 5 (2020)
ORIGINAL PAPERS
Submitted: 2020-05-20
Accepted: 2020-07-22
Published online: 2020-10-24

Abstract

Introduction: Cough is one of the most frequent symptoms reported to pulmonologists. The role of bronchoscopy in the diagnostic work-up of chronic cough is not clearly defined. The aim of this study was to evaluate the utility of fiberoptic bronchoscopy (FOB) and additional testing of samples collected during FOB in the differential diagnosis of chronic cough in adults.
Material and methods: This was a single-center retrospective study. Out of 7115 conventional white light FOB examinations, we finally selected 198 with cough as the only indication.
Results: In 40.9% of bronchoscopic examinations, no visible cause of cough was found. Visual signs of chronic bronchitis (CB) were detected in 57.6% of reports. Only in 3 cases (1.5%) bronchoscopy revealed a potential cause of chronic cough other than CB. Mycobacterium tuberculosis or other mycobacteria were spotted in none of the samples. In 91.1% of bronchoalveolar lavage (BAL) cytologic examinations, at least one cell count abnormality was detected, but only in case of increased percentage of eosinophils, it might be considered clinically relevant. In 53% of bacteriological culture results, at least one potentially pathogenic bacterium was isolated.
Conclusions: The present study results strengthen the evidence that FOB combined with additional testing of airway specimens obtained during FOB is not a powerful tool in the differential diagnosis of chronic cough, and FOB as a diagnostic tool may be overused. The appropriate timing and decision regarding referral for FOB and additional testing of achieved material requires careful clinical consideration.

Abstract

Introduction: Cough is one of the most frequent symptoms reported to pulmonologists. The role of bronchoscopy in the diagnostic work-up of chronic cough is not clearly defined. The aim of this study was to evaluate the utility of fiberoptic bronchoscopy (FOB) and additional testing of samples collected during FOB in the differential diagnosis of chronic cough in adults.
Material and methods: This was a single-center retrospective study. Out of 7115 conventional white light FOB examinations, we finally selected 198 with cough as the only indication.
Results: In 40.9% of bronchoscopic examinations, no visible cause of cough was found. Visual signs of chronic bronchitis (CB) were detected in 57.6% of reports. Only in 3 cases (1.5%) bronchoscopy revealed a potential cause of chronic cough other than CB. Mycobacterium tuberculosis or other mycobacteria were spotted in none of the samples. In 91.1% of bronchoalveolar lavage (BAL) cytologic examinations, at least one cell count abnormality was detected, but only in case of increased percentage of eosinophils, it might be considered clinically relevant. In 53% of bacteriological culture results, at least one potentially pathogenic bacterium was isolated.
Conclusions: The present study results strengthen the evidence that FOB combined with additional testing of airway specimens obtained during FOB is not a powerful tool in the differential diagnosis of chronic cough, and FOB as a diagnostic tool may be overused. The appropriate timing and decision regarding referral for FOB and additional testing of achieved material requires careful clinical consideration.

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Keywords

fiberoptic bronchoscopy; cough; differential diagnosis; bacterial cultures; bronchoalveolar lavage

About this article
Title

The role of bronchoscopy in diagnosis of chronic cough in adults: a retrospective single-center study

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 5 (2020)

Article type

Research paper

Pages

406-411

Published online

2020-10-24

DOI

10.5603/ARM.a2020.0140

Pubmed

33169812

Bibliographic record

Adv Respir Med 2020;88(5):406-411.

Keywords

fiberoptic bronchoscopy
cough
differential diagnosis
bacterial cultures
bronchoalveolar lavage

Authors

Patryk A Sobczak
Justyna M Sobczak
Sebastian Majewski
Joanna Miłkowska-Dymanowska
Zofia Kurmanowska
Karolina Szewczyk
Ewa Tyczkowska-Sieroń
Adam J Białas
Adam Antczak
Paweł Górski
Wojciech J Piotrowski

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