What is and what causes Bronchiectasis?
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
What are the signs and symptoms of Bronchiectasis?
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
What is the pathophysiology of Bronchiectasis?
- 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
What diagnotic tests and treatments are usual for Bronchiectasis?
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
