What is bronchiectasis?
- Permanent dilatation of the airways
- Secondary to chronic infection or inflammation
- Wide variety of causes
What are congenital causes of bronchiectasis?
Cystic fibrosis → most common
- Kartagener's syndrome
- Young's syndrome
What are post-infective causes of bronchiectasis?
Other causes → UC / RA / bronchial obstruction
What are the clinical features of bronchiectasis?
- Persistent cough
- Copioid purulent sputum
- Intermittent haemoptysis
- Signs → clubbing / coarse insp creps / wheeze
What are complications of bronchiectasis?
- Pleural effusion
What may sputum culture show for bronchiectasis?
- Single or multiple pathogens present
- Most common (25%) = gram-negative → pseudomonas aeruginosa
What other investigations are done for bronchiectasis?
CXR → cystic shadows / thickened bronchial walls
CT → extent + distribution / dilated bronchus wider than accompanying pulm artery + resemble signet ring
Spirometry → obstructive pattern
Bronchoscopy → site of haemoptysis / exclude obstruction / obtain culture samples
Other tests → serum Igs / CF sweat test / Aspergillus preceiptans or skin-prick test RAST + total IgE
What is the management of bronchiectasis?