Share your insights

Help us by sharing what content you've recieved in your exams


Bronchiectasis

Definition
  • A chronic condition characterised by permanent dilation and destruction of the bronchial walls due to recurrent inflammation and infection.
Etiology
  • Post-infective (e.g., childhood pneumonia, tuberculosis).
  • Cystic fibrosis.
  • Primary ciliary dyskinesia (Kartagener syndrome).
  • Foreign body aspiration.
  • Autoimmune diseases: rheumatoid arthritis, ulcerative colitis.
  • Idiopathic (cause unknown).
Clinical Presentation
  • Chronic productive cough with copious amounts of purulent sputum.
  • Hemoptysis (coughing up blood).
  • Recurrent chest infections.
  • Dyspnoea (shortness of breath).
  • Clubbing of fingers.
  • Wheezing and chest pain.
Investigations
  • High-resolution CT (HRCT) scan: “Cystic” or “tubular” appearance of bronchi, “signet ring” sign.
  • Chest X-ray: Non-specific changes, including increased lung markings.
  • Sputum cultures to identify infective organisms.
  • Pulmonary function tests: Obstructive pattern with reduced FEV1/FVC ratio.
  • Bronchoscopy (if indicated).
Management
  • Physiotherapy: Postural drainage, chest physiotherapy.
  • Regular antibiotics based on sputum culture results. Long-term macrolides (e.g., azithromycin) in recurrent exacerbations.
  • Inhaled bronchodilators (e.g., salbutamol).
  • Mucolytics (e.g., carbocisteine).
  • Vaccination: Annual flu and pneumococcal vaccines.
  • Surgical: Lobectomy or segmentectomy in localised disease, lung transplantation in severe cases.
Complications
  • Recurrent respiratory infections.
  • Respiratory failure.
  • Cor pulmonale (right-sided heart failure due to lung disease).
  • Empyema (pus in the pleural space).
Prognosis
  • Varies based on severity. Regular treatment and monitoring can improve quality of life and slow progression.

No comments yet šŸ˜‰

Leave a Reply