Bronchiectasis

Question 1

What is bronchiectasis?

Answer 1

Permanent dilatation of the airways secondary to chronic infection or inflammation.

Question 2

What are some of the causes of bronchiectasis?

Answer 2

1. Post-infective: tuberculosis, measles, pertussis, pneumonia
2. Cystic fibrosis
3. Bronchial obstruction e.g. lung cancer/foreign body
4. Immune deficiency: selective IgA, hypogammaglobulinaemia
5. Allergic bronchopulmonary aspergillosis (ABPA)
6. Ciliary dyskinetic syndromes (Kartagener’s syndrome, Young’s syndrome)
7. Yellow nail syndrome

Question 3

What are the characteristic signs of bronchiectasis seen on x-ray?

Answer 3

Tramlines/Tram-track sign

Signet ring signs

Question 4

What is the management of bronchiectasis?

Answer 4

Treatable causes (immune deficiency)
Physical training/physiotherapy
Postural drainage
Antibiotics for exacerebations + long-term rotating antibiotics in severe cases
Bronchodilators in selected cases
Immunisations
Surgery in selected cases

Question 5

What are the most common organisms isolated from patients with bronchiectasis?

Answer 5

Haemophilus influenzae (most common)
Pseudomonas aeruginosa
Klebsiella spp
Streptococcus pneimoniae