Bronchiectasis Flashcards
What is the pathology of bronchiectasis?
chronic inflammation of the bronchi and bronchioles leading to permanent dilation and thinning of these airways
What are the main organisms that cause bronchiectasis
H. influenzae
Strep. Pneumoniae
Staph. Aureus
Pseudomonas aeruginosa
What are the main congenital causes of brochiectasis?
- Cystic Fibrosis
- Young’s Syndrome
- Primary Ciliary dyskinesia
- Kartagener’s syndrome
What are the main post-infection causes of bronchiectasis?
- Measles
- Pertussis
- Bronchiolitis
- Pneumonia
- TB
- HIV
What are the main other causes of brochiectasis?
- Bronchial obstruction (tumour, foreign body)
- Allergic bronchopulmonary aspergillosis (ABPA)
- Hypogammaglobulinemia
- Rheumatoid arthritis
- Ulcerative colitis
- Idiopathic
What are the main symptoms of brinchiectasis?
o Persistent cough
o Copious purulent sputum
o Intermittent haemoptysis
What are the main clinical signs of brochiectasis?
o Finger clubbing
o Coarse inspiratory crepitations
o Wheeze (asthma, COPD, ABPA)
What are the main complications of bronchiectasis?
o Pneumonia o Pleural effusion o Pneumothorax o Haemoptysis o Cerebral abscess o Amyloidosis
What tests should be carried out in bronchiectasis?
• Sputum culture • CXR o Cystic shadows o Thickened bronchial walls (tramline and ring shadows) • HRCT chest – to assess extent and distribution of the disease • Spirometry – obstructive pattern • Bronchoscopy o To locate the site of haemoptysis o Exclude obstruction o Obtain samples for culture • Other tests: o Serum immunoglobulins o CF sweat test o Aspergillus precipitins or skin-prick test o RAST o Total IgE
What techniques are used in the management of bronchiectasis?
• Airway clearance techniques and mucolytics
• Antibiotics
o Pseudomonas will require oral ciprofloxacin or suitable IV antibiotics
• Bronchodilators
o Patients with asthma, COPD, CF, asthma
• Corticosteroids
o And itraconazole for ABPA
• Surgery – may be indicated for localised disease or to control severe haemoptysis
