Bronchiectasis

Question 1

What is bronchiectasis?

Answer 1

Chronic inflammation of the bronchi which cause a productive cough, secondary to chronic infection of inflammation

Mucus plugs form which obstruct airflow

Question 2

What are the main causative organisms of bronchiectasis?

Answer 2

H.Influenzae
Strep. pneumoniae
Staph aureus
Pseudomonas

Question 3

What are the symptoms of bronchiectasis?

Answer 3

Productive cough
Large volumes of sputum
May have some haemoptysis
Breathlessness

Question 4

What conditions can cause bronchiectasis?

Answer 4

Cystic fibrosis
Primary ciliary dyskinesia
Kartagener’s Syndrome

Post infection- Pneumonia, TB, HIV

Obstruction- Tumour, foreign body e.g. aspirated

Immune deficiency- IgA

Question 5

What causes bacterial overgrowth in bronchiectasis?

Answer 5

Stasis of the mucus allows for bacterial overgrowth leading to the chronic inflammation

Question 6

What are some signs of bronchiectasis?

Answer 6

Finger clubbing
Crepitations
Wheeze due to obstruction

Question 7

What are some complications of bronchiectasis?

Answer 7

Recurrent pneumonia
Pleural effusion
Pneumothorax
Haemoptysis

Question 8

What tests would you do is suspecting bronchiectasis?

Answer 8

CXR- thickened bronchial walls, tramline and ring shadows
Sputum- MC+S
HRCT- Allows to assess extent of the disease, wide spread dilatation of the bronchi
Spirometry- obstructive pattern
Bronchoscopy- can investigate for other causes of haemoptysis

May want to test for CF (Sweat test, genetic testing) or Primary ciliary dyskinesia (Genetics)

Question 9

What is the treatment for bronchiectasis?

Answer 9

Airway clearance techniques- Physio
Mucolytics- Carbocisteine
Antibiotics- guided by sensitivity of sputum culture
Bronchodilators
Surgery if localized disease or to control haemoptysis