Bronchiectasis is a chronic lung condition characterized by permanent dilation of the airways caused by long-term infection and inflammation. Common infectious organisms include Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus. It can be caused by congenital issues, cystic fibrosis, infections like measles or pneumonia, or other conditions such as primary biliary cirrhosis. Symptoms include a persistent cough and production of copious purulent sputum. Management involves postural drainage, chest physiotherapy, antibiotics, and bronchodilators.

1. Bronchiectasis
Chronic infection of the bronchi and bronchioles leading to permanent
dilatation of the airways

2. Main organisms
• H.Influenzae
• Strep. Pneumoniae
• Staph. Aureus
• Pseudomonas Aeruginosa

3. Causes
• Congenital
• Cystic fibrosis
• Young syndrome
• Primary biliary dyskinesia
• Kartagener's syndrome
• Post-infection
• Measles
• Pertussis
• Bronchiolitis
• Pneumonia
• TB
• HIV
• Other
• Bronchial obstruction (FB,tumor)
• ABPA
• Hypogammaglobulinemia
• RA
• Ulcerative colitis
• idiopathic

4. Clinical features
• Symptoms
• Persistent cough
• Copius purulent sputum
• Intermittent haemoptysis

5. Clinical features
• Signs
• Inspection
• Finger clubbing
• Palpation
• Percussion
• Auscultation
• Coarse crepitation
• Wheeze (asthma,COPD,ABPA)

6. Complications
• Pneumonia
• Pleural effusion
• Pneumothorax
• Haemoptysis
• Cerebral abscess
• Amyloidosis

7. Tests
• Sputum culture
• CXR
• Cystic shadows
• Thickened bronchial walls (tramline and ring shadows)
• HRCT
• Assess extent and distribution of disease
• Spirometry
• Obstructive pattern(assess reversibility)
• Bronchoscopy
• Locate site of haemoptysis
• Exclude obstruction
• Other
• Serum immunoglobulins
• CF sweat test
• Aspergillus precipitins
• Skin prick test

8. Management
• Postural drainage
• Twice daily
• Chest physiotherapy
• Aid sputum expectoration and mucous drainage
• Antibiotics
• Pseudomonas – oral ciprofloxacin or IV antibiotics
• Bronchodilators
• Nebulised salbutamol – COPD,asthma,ABPA
• Corticosteroids – ABPA
• Surgery – localized disease / control severe hemoptysis