Abstract
The evolution of the concept of PBB is analyzed over time since it
appeared as protracted bronchitis1, later protracted bacterial
bronchitis (PBB)2, and finally its “clinical” version3, which avoids
the need to perform fiberoptic bronchoscopy in children. However, this
deviates in a significant manner from the principle on which the concept
is based, giving rise to the idea of a disease that only affects
children with the main characteristic of bacteriological isolation from
lower airways. On the other hand, the clinical diagnosis of PBB is made
by excluding other diseases through so-called “pointers to specific
cough (primarily for chronic cough)”1 with a posterior reference of
signs and symptoms called specific cough pointers2 and finally, in 2020,
“Pointers to presence of specific cough”.4 Comments are then made on
how asthma (and early wheezing) and posterior nasal drip syndrome are
ruled out as important causes of chronic and recurrent cough in
children. In conclusion, the causes of acute and chronic cough in
children, with a few exceptions, are quite comparable to the causes of
cough in adults. Therefore, an easy and more accurate way of diagnosing
cough in children could be to reconsider our concepts of so-called cough
pointers, upper airway cough syndrome, and asthma (and early wheezing)
in children.