My Clinical Notes
Bronchiectasis
- Chronic infection of the bronchi an bronchiole leading to permanent dilation of the airways
- Main organisms – H. influenzae, Strep, pneumoniae, Staph aureus, Pseudomonas aeruginosa
Causes;
- Congenital;
- Primary ciliary dyskinesia
- Kartagener’s syndrome
- Post-infection;
- Measles
- Pertussis
- Bronchiolitis
- Pneumonia
- TB
- HIV
- Other;
- Bronchial obstruction
- Allergic bronchopulmonary aspergillosis (ABPA)
- Hypogammaglobulinaemia
- RA
- UC
Clinical features
- Persistent cough, purulent sputum, intermittent haemoptysis
- Clubbing, coarse inspiratory crackles, wheeze
Complications;
- Pneumonia
- Pleural effusion
- Pneumothorax
- Haemoptysis
- Cerebral abscess
- Amyloidosis
Investigations
- Sputum culture
- CXR – cystic shadows, thickened bronchial walls
- HRCT
- Spirometry – assess reversibility
- Bronchoscopy
- Serum Ig, CF sweat test, Aspergillus precipitans, skin prick test
Management
- Postural drainage
- Antibiotics
- Bronchodilators
- Corticosteroids
- Surgery may be indicated in localized disease or to control haemoptysis
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