Bronchiectasis Flashcards
Main organisms which infect patients with bronchiectasis
H. influenzae
Strep pneumoniae
Staph aureus
Pseudomonas aerugnosa
Causes of Bronchiectasis
Cystic Fibrosis
Post infection (measles, pertussis, bronchiolitis, pneumonia, TB, HIV)
Bronchial obstruction (tumour, foreign body)
Allergic Bronchopulmonary Aspergilliosis (ABPA)
Hypogammaglobulunaemia
Rheumatoid arthritis/ ulcerative colitis
Idiopathic
Symptoms of bronchiectasis
Persistent productive cough Copious purulent sputum Intermittent haemoptysis Persistent halitosis Finger clubbing Breathlessness (airflow limitation)
Signs of bronchiectasis
Finger clubbing
Coarse inspiratory crackles
Wheeze
Complications of bronchiectasis
Pneumonia Pleural effusion Pneumothorax haemoptysis Amyloidosis Cerebral abscess
Investigations for bronchiectasis
CXR (dilated bronchi, thickened walls p, multiple cysts)
CT (thick dilated bronchi with cysts, assess extent of disease)
Spirometry (can show obstructive pattern)
Sputum culture (identify organism)
Bronchoscopy (exclude obstruction, locate haemoptysis, get sample)
What is postural drainage?
Used in bronchiectasis treatment
Performed twice a day
Tip of side of bed
Trained by physio
Antibiotics for treatment of bronchiectasis
Ciproflooxacin - 500mg 3X daily
Flu location - 500mg 4X daily (if staph aureus)
If > 3 exacerbations a year consider long term antibiotics
When are bronchodilators useful in bronchiectasis?
Patients with airflow limitation
When can surgery be used in bronchiectasis?
If disease is localised
To treat severe haemoptysis
What is bronchiectasis?
Abnormal and permanently dilated airways caused by chronic infection
Bronchial walls become inflamed, thickened and irreversibly damaged
Much ciliary ,echo ism is impaired and bacterial infections occur frequently.
