Bronchiectasis

Question 1

What is and what causes Bronchiectasis?

Answer 1

Abnormal permenant airway dilation through tissue destruction of proximal medium bronchi - relatively uncommon

Causes problems in normal dilation and constriction, so you get a ‘stagnant swamp’

May be congenital or acquired – repeated infection, autoimmune disease and cystic fibrosis are among the causes of the acquired disease

Question 2

What are the signs and symptoms of Bronchiectasis?

Answer 2

Signs and symptoms
* Cough
* Mucopurulent sputum production, occurring daily, often lasting months to years
* If acute infection present, blood-streaked sputum or haemoptysis from airway damage
* Dyspnoea and wheezing
* Pleuritic chest pain
* Fever, weakness and fatigue
* Weight loss

Question 3

What is the pathophysiology of Bronchiectasis?

Answer 3

• Initial infection happens – inflammatory cytokines, neutrophils, oxygen radicals
• This causes damage throughout the bronchial wall, alveoli closest to bronchi can be damaged and suffer fibrosis, drainage of lung secretions impaired
• Secondary persistent bacterial infection due to fluid stagnation can cause extensive damage to lung tissue

Question 4

What diagnotic tests and treatments are usual for Bronchiectasis?

Answer 4

Key diagnostic tests:
* Case history and physical examination
* Sputum analysis
* CT scan to confirm the diagnosis

Conventional treatment
* Antibiotics for secondary infection
* Physiotherapy to improve
respiratory drainage
* Bronchodilators and steroids