Bronchiectasis is a chronic lung disease involving the abnormal widening of the bronchi. It can be congenital or acquired after birth, usually due to a severe lung infection that damages the bronchial tubes. Common causes include recurrent lung infections, tuberculosis, cystic fibrosis, and immunodeficiency disorders. Symptoms vary but often include a chronic cough with sputum, repeated lung infections, shortness of breath, and wheezing. Diagnosis involves physical exam, imaging tests, and pulmonary function tests. Treatment focuses on controlling infections with antibiotics, loosening mucus with medications, and preventing worsening of the condition.

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UNIVERSIDAD TECNICA DE MACHALA
ACADEMIC UNIT OF CHEMICAL
SCIENCES AND HEALTH
MEDICINE SCHOOL
ENGLISH
BRONCHIECTASIS
STUDENTS
William Cruz
Kevin Herrera
TEACHER:
Mgs. Barreto Huilcapi Lina Maribel
CLASS:
EIGHTH SEMESTER ‘’A’’
Machala, El Oro
2018

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Bronchiectasis
Definition
Bronchiectasis is a chronic inflammatory disease of the airways that involves the
dilation of the bronchi. As Araceli Caballero, member of the Spanish Society of
Pediatric Pulmonology, affirms, "it is an irreversible damage that we will not be able
to solve, the only thing we can do is try to mitigate the possible complications to
prevent them from progressing". It affects the major airways and causes its widening.
It can be congenital, if the baby is born with it, or acquired bronchiectasis, if it is
contracted after birth. It usually occurs first thanks to an aggression of the respiratory
system, which is usually an infection that attacks the bronchial tree of the lungs.
Etiology
One of the most frequent causes is infection or recurrent inflammation of the
respiratory tract and the bronchial mucosa. Cases of bronchiectasis due to infection
account for 35 percent, among which most are due to tuberculosis. It can be suffered

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after passing a severe respiratory infection or if a foreign body has been introduced
into the patient's airway. Other possible causes are cystic fibrosis and some genetic
conditions.
Immunodeficiencies, some systemic pathologies, congenital alterations and other
diseases increase the risk of suffering from bronchiectasis. HIV weakens the patient's
immune system and helps infections to settle in the body and suffer from the disease.
Diffuse bronchiectasis develops more frequently in patients with genetic,
immunological or anatomical defects that affect the airways. In developed countries,
many cases initially appear to be idiopathic, probably in part because the onset is so
slow that the triggering problem can not be identified by the time bronchiectasis is
recognized. With the new improved genetic and immunological tests, a growing
number of reports describe the finding of an etiology in these idiopathic cases after a
careful and systematic evaluation.
Cystic fibrosis (CF-see Cystic Fibrosis) is the most common identified cause, and
previously undiagnosed CF can account for up to 20% of idiopathic cases. Even
heterozygous patients, who usually do not have clinical manifestations of CF, may
have an increased risk of bronchiectasis.
Immunological deficiencies such as common variable immunodeficiency (CVID)
also lead to diffuse disease, as do rare abnormalities in the structure of the airways.
Malnutrition and HIV infection also seem to increase the risk.
Congenital defects in the mechanism of mucociliary clearance, such as primary
ciliary dyskinesia (PCD) syndromes can also be a cause and possibly also explain
some idiopathic cases.
Diffuse bronchiectasis sometimes complicates more common autoimmune
conditions, such as rheumatoid arthritis or Sjögren's syndrome.
Signs and symptoms

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The symptomatology in the patient is presented progressively. The time depends on
the case. It can happen from a few weeks, until years after the event that causes
bronchiectasis. The symptoms are varied and may include:
 Skin with blue color.
 Halitosis or bad mouth breath.
 Chronic cough with fetid sputum (phlegm originated in the lung with a bad
smell): it is accompanied by expectoration (expulsion from the mouth of
substances that come from the lungs) and is stronger in the mornings due to
the secretions accumulated by the patient. the night.
 Repeated bronchial infections.
 Swollen fingers of the hand in the most distal part (in drumstick).
 Expectoration with blood originating in the bronchi or lungs.
 Fever.
 Cough when the patient lies down, especially on the side. Cough usually
produces expectoration with pus.
 Fatigue.
 Thoracic pain.
 Pallor.
 Dyspnea or respiratory problems and progressive decline in lung function,
especially when playing sports.
 Weight reduction
 Wheezing or sound that makes air that is generated in the airways when they
are clogged or congested.
Diagnosis
The health care provider will perform a physical exam. When listening to the thorax
with a stethoscope, the provider may notice small clicking, bubbling, wheezing,
jingling, or other noises, usually in the lower part of the lungs.
Tests that can be done include:

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 Precipitin test for aspergillosis (to check for signs of an allergic reaction to the
fungus)
 Blood test for alpha-1-antitrypsin
 X-ray of the chest
 Computed tomography of the thorax
 Sputum culture
 Complete blood count (CSC)
 Genetic tests, including sweat test for cystic fibrosis and tests for other
diseases
 Skin test of PPD (purified protein derivative) to check for tuberculosis
infection in the past
 Serum immunoglobulin electrophoresis to measure proteins called
immunoglobulins in the blood
 Pulmonary function tests to measure breathing and how well the lungs are
working.
Treatment
The treatment is aimed at controlling infections and sputum, alleviating airway
obstruction and preventing the problem from getting worse.
Part of the treatment is daily drainage to eliminate sputum. A respiratory therapist can
teach the person expectoration exercises (spitting up the mucus) that can help.
Medications are often prescribed. These include:
 Antibiotics to treat infections
 Bronchodilators to open the airways
 Expectorants to help loosen and discard thick sputum
 Surgery may be needed to remove (remove) the lung if the medications do not
work and the disease is in a small area, or if the person has a lot of bleeding in
the lungs.

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Prevention
One of the measures to prevent bronchiectasis is to avoid lung infections such as
pneumonia (infection of the lung parenchyma). To dodge infections such as
whooping cough or measles, it is best to get vaccinated against them.
Another recommendation is to put patients of any age in the annual influenza and
pneumococcal vaccine, to try to reduce the exacerbations.
Tobacco and contamination are factors that increase the possibility of suffering an
infection and therefore, bronchiectasis. It is recommended to escape from these habits
and maintain an environmental control of the area where it is mainly inhabited.
Bibliography
 Chan ED, Iseman MD. Bronchiectasis In: Broaddus VC, Mason RJ, Ernst JD,
et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed.
Philadelphia, PA: Elsevier Saunders; 2016: chap 48.
 O'Donnell AE. Bronchiectasis, atelectasis, cysts, and localized lung disorders.
In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed.
Philadelphia, PA: Elsevier Saunders; 2016: chap 90.
 King PT, Holdsworth SR, Freezer NJ, et al. Characterization of the onset and
presenting clinical features of adult bronchiectasis. Respir Med 2006; 100:
2183.