Bronchiectasis
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Bronchiectasis is a chronic lung condition characterised by an abnormal widening and loss of elasticity of the bronchi/bronchioles.
Aetiology
Persistent respiratory infections, such as pneumonia and tuberculosis.
Obstruction of the airways caused by an inhaled foreign object or a tumour.
Genetic disorders e.g. including cystic fibrosis or primary ciliary dyskinesia.
Autoimmune diseases, such as rheumatoid arthritis and Sjogren's syndrome.
Pathophysiology
There is an impairment of the normal clearance of mucus and bacteria.
Accumulation of mucus = ideal environment for bacteria growth/colonisation.
Persistent infections and inflammation damage the airways over time, perpetuating the cycle of dilation and poor clearance.
Risk factors
Recurrent respiratory infections.
Genetic factors.
Immunodeficiency.
Chronic lung diseases: e.g. chronic obstructive pulmonary disease (COPD), asthma, or TB.
Autoimmune diseases: e.g. rheumatoid arthritis, Sjögren's syndrome, and inflammatory bowel disease.
Gastroesophageal reflux disease (GERD).
Environmental factors: e.g. environmental pollutants, toxic fumes, or some occupational hazards.
Age: older individuals are at higher risk.
Sign and symptoms
Productive cough.
Breathlessness.
Haemoptysis.
Chest pain.
Coarse crackles.
Wheeze.
Diagnosis and investigations
Sputum culture.
Chest X-ray.
Spirometry.
Blood test: FBC (raised WCC), raised CRP.
Management
Important to perform a sputum culture.
Empirical treatment: amoxicillin is 1st line treatment.
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