Bronchiectasis is a chronic lung disease that causes the bronchial tubes to widen permanently. It can be congenital or acquired after birth, usually due to a lung infection that damages the bronchial tubes. Common causes include recurrent lung infections, tuberculosis, cystic fibrosis, and immunodeficiencies. Symptoms include chronic cough with sputum, repeated lung infections, shortness of breath, fatigue, and wheezing. Diagnosis involves physical exam, chest x-ray, CT scan, and pulmonary function tests. Treatment focuses on controlling infections with antibiotics, loosening mucus with medications, and preventing worsening of the condition.

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

2. 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 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.

3. 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
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

4. 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:
 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

5.  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.
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.

6. 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.