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Chronic Cough Due to Nonbronchiectatic Suppurative Airway Disease (Bronchiolitis)

ACCP Evidence-Based Clinical Practice Guidelines

Correspondence to: Kevin K. Brown, MD, FCCP, National Jewish Medical and Research Center, 1400 Jackson St, Denver, CO 80206; e-mail: brownk{at}njc.org

Objectives: To review the role of nonbronchiectatic suppurative airway disease (bronchiolitis) in the spectrum of causes of cough and its management.

Design/methodology: A MEDLINE search (through May 2004) for studies published in the English language since 1980 on human subjects using the medical subject heading terms "cough," "causes of cough," "etiology of cough," "interstitial lung disease," "bronchiolitis," "bronchiolitis obliterans," "diffuse panbronchiolitis," and "inflammatory bowel disease" was performed. Case series and prospective descriptive clinical trials were selected for review. Any references from these studies that were pertinent to the topic were also obtained.

Results/conclusions: In patients with cough in whom other more common causes of cough have been excluded, incomplete or irreversible airflow limitation, small airways disease seen on high-resolution CT scan, or purulent secretions seen on bronchoscopy, should suggest nonbronchiectatic suppurative airways disease (bronchiolitis) as a potential primary cause. Successful management depends on the identification of the specific underlying disorder.

Key Words: bronchiolitis • diffuse panbronchiolitis • inflammatory bowel disease • small airways disease

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				R. S. Irwin, M. H. Baumann, D. C. Bolser, L.-P. Boulet, S. S. Braman, C. E. Brightling, K. K. Brown, B. J. Canning, A. B. Chang, P. V. Dicpinigaitis, et al. Diagnosis and Management of Cough Executive Summary: ACCP Evidence-Based Clinical Practice Guidelines Chest, January 1, 2006; 129(1_suppl): 1S - 23S. [Full Text] [PDF]