Bronchiectasis Flashcards
Pathology
Chronic inflammation of the bronchi and bronchioles leading to permenant dilation and thinning of these airways
Main organisms causing bronchiectasis
Hameophilus influenzae
Streptococcus pneumoniae
Staphylococcus aureus
Pseudomonas aeruginosa
Congenital causes
Cystic fibrosis
Youngs syndrome
Primary ciliary dyskinesia
Kartageners syndrome
Post-infection causes
Measles Bronchiolitis Pneumonia TB HIV
*Other causes of bronchiectasis (not congenital or post-infection)
Bronchial obstruction (tumour, foreign body) Allergic bronchopulmonary aspergillosis Ulcerative colitis Rheumatoid arthritis Idiopathic Hypogammaglobulinaemia
Symptoms
Persistent cough
Purulent sputum
Fever
Signs
Finger clubbing
Crepitations
Coarse inspiratory crackles
Complications
Pneumonia Pleural effusion Pneumothorax Haemoptysis Cerebral abscess Amyloidosis
Tests
Sputum (culture) CXR HRCT chest Spirometry Bronchoscopy Others: Serum Igs, CF sweat test, Aspergillus preciptins or Skin prick test RAST and total IgE
What pattern would you expect to see on a spirometry of bronchiectasis
Obstructive pattern
Describe CXR of bronchiectasis
Cystic shadows
Thickened bronchial walls (tramline and ring shadows)
Management
Airway clearance techniques and mucolytics Antibiotics Pseudomonas Bronchodilators Corticosteroids Surgery
What can be done to aid sputum expectoration and mucus drainage
Chest physiotherapy and flutter valves
Management: What can be given as pseudomonas
Oral Ciprofloxacin
Or
Suitable IV antibiotics
(if at least 3 exacerbations a year then consider long-term antibiotics)
Management: when would you give surgery
localised disease or to control severe haemoptosysis
