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Bronchiectasis
Chronic infection of the bronchi and bronchioles leading to permanent
dilatation of the airways
Main organisms
• H.Influenzae
• Strep. Pneumoniae
• Staph. Aureus
• Pseudomonas Aeruginosa
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
Clinical features
• Symptoms
• Persistent cough
• Copius purulent sputum
• Intermittent haemoptysis
Clinical features
• Signs
• Inspection
• Finger clubbing
• Palpation
• Percussion
• Auscultation
• Coarse crepitation
• Wheeze (asthma,COPD,ABPA)
Complications
• Pneumonia
• Pleural effusion
• Pneumothorax
• Haemoptysis
• Cerebral abscess
• Amyloidosis
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
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

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Bronchiectasis

  • 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