Bronchiectasis Flashcards
What is the definition of bronchiectasis?
Permanent widening of the airways - irregular dilatation of airways, close to pleura
Have increased mucus, damaged wall, loss of cilia
What is bronchiectasis caused by?
Destruction of muscle and elastic tissue secondary to recurrent inflammation
What are the causes and associations of bronchiectasis?
Idiopathic, post infective, ciliary dysfunction, immune deficiency, aspiration
CF, RA, IBD, congenital, atypical mycobacteria, Young’s syndrome
What is the clinical presentation of bronchiectasis?
Cough
Sputum production
Breathlessness
Rhinosinusitis, fatigue, haemoptysis, thoracic pain
SOB, coarse crackles, wheeze, clubbing, weight loss
What are the investigations for bronchiectasis?
CXR - often normal, can have thickening bronchi HRCT Differential blood count Serum immunoglobulins (IgG, IgA, IgM) Sputum Bronchoscopy
What are the findings of bronchiectasis on HRCT?
Lack of tapering, increased broncho-arterial ratio, bronchial wall thickening, mucus impaction, air trapping, tram track sign, signet ring sign
What are the complications of bronchiectasis?
Recurrent infections Pneumonia Lung abscess Empyema Sepsis
What is the treatment for bronchiectasis?
No previous bacteriology - amoxicillin 500mg TDS 14 days
Severe/haemophilus influenzae - amoxicillin 1g TDS 14 days
Pseudomonas aeruginosa - ciprofloxacin