bronchiectasis

Chronic inflammation of bronchi and bronchioles leading to permanent dilation and thinning. Easily collapsible - obstructive lung disease

Causes/Factors

• Congenital: Cystic Fibrosis, Young’s Syndrome, Kartagener’s Syndrome, Alpha-1 antitrypsin deficiency
• Post-infection: measles, Pertussis, pneumonia, Tuberculosis, HIV
• Other: Immunodeficiencies

Symptoms

• Persistent productive cough (green/yellow colour)
• Dyspnoea
• Halitosis (bad breath)
• Repeated chest infections

Signs

• Finger clubbing
• Coarse inspiratory crepitations heard
• Hypoxaemia
• Hypercapnia (high $C{O}_2$)

Diagnostic Tests

• Sputum culture

• CXR/high res CT to assess extent - signet ring sign - bronchioles larger than arteries (abnormal)

• ABG ($\downarrow Pa{O}_2,\uparrow PaC{O}_2$)

Management

• Airway clearance techniques & mucolytics
• Antibiotics - nebulised for pseudomonas
• Maintaining body weight/nutrition
• Corticosteroids
• Surgery if localised

Complications

• Infective exacerbation - most common organism: Haemophilus influenzae