Bronchiectasis Flashcards
What is Bronchiectasis?
Dilation of a bronchus caused by recurrent inflammation and remodelling
What can cause Bronchiectasis?
- CF (most cases)
- RA
- UC
- Idiopathic
- Kartagener’s
Which two bacteria are particularly likely to cause Bronchiectasis?
- Haemophilus influenzae
- Mycobacterium tuberculosis
How might Bronchiectasis present?
- Persistent productive cough (blood and sputum)
- Dyspnoea
When is blood present in the sputum?
Only during infective periods due to small vessel damage bleeding into alveoli
What signs might you find on examination?
- Crepitations (coarse inspiration)
- Expiratory wheeze
- Clubbing
What bloods should you do?
- ABG
- Infection markers
What imaging could you do? What would you find with each?
CXR- Grainy/reticular pattern
Bronchoscopy with culture of tissue- pathogen and macro appearance
HRCT- to see the extend of disease
What other test should be done?
Sputum culture
What conservative treatment measure should you use?
Airway and chest physio/clearance techniques e.g. coughing
What medical treatments may be indicated?
- ABx- see local guidelines
- Bronchodilators- PRN SABA and steroid maintenance inhalers
When should you consider prophylactic ABx long term?
3+ exacerbations in a year
What does it mean if you have exacerbations on top of your prophylactic ABx?
A second infective organism
What are the possible complications of Bronchiectasis?
- Pneumonia (CAP is a cause AND a complication)
- Pleural effusion
- Pneumothorax
Name four organisms that may cause pneumonia in these Pts.
- Haemophilus influenzae
- Staph aureus
- Strep pneumoniae
- Pseudomonas aureginosum
