Card Set Information
What is bronchiectasis?
Permanent dilatation of bronchi
What is the main pathogenesis of bronchiectasis?
Chronic infection of bronchi and bronchioles
What are the main organisms causing bronchiectasis?
What are the congenital causes of bronchiectasis?
1. ciliary dyskinesia
a. primary ciliary dyskinesia
: immotile cilia
b. kartaganers syndrome
: immotile cilia, situs invertus, chronic sinusitis
c. young’s syndrome
: bronchiectasis and absent vas deferens
2. cystic fibrosis
3. Ig deficiency (IgG2, 4) due to recurrent infections
What are the acquired causes of bronchiectasis?
1. Post infective bronchial damage:
a. Childhood infections
: pertussis, measles, bronchiolitis
2. Airway obstruction
a. Inhaled foreign body
c. Enlarged LN
3. Acquired immunodeficiency – AIDS (histoplasmosis fungal infection)
What are the symptoms of bronchiectasis?
Copious purulent sputum
What are the signs of bronchiectasis?
Coarse inspiratory crepitations (lung bases usually)
What are the complications of bronchiectasis?
Eventually respiratory failure
Which Ix need to be done to diagnose bronchiectasis?
Bronchoscopy – to locate site of haemoptysis or exclude obstruction
What does CXR show in bronchiectasis?
Thickened bronchial walls (tramline and ring shadows)
Multiple cysts containing fluid → cystic shadows
What is the one investigation of choice to diagnose bronchiectasis and what does it show?
bronchial wall thickening,
bronchial wall cysts
which investigations need to be done in an infective exacerbation of bronchiectasis?
What would spirometry show in bronchiectasis?
Is bronchiectasis usually confined or widespread?
Confined to a lobe if due to inhaled foreign body or lobar pneumonia
What are the most frequently isolated organisms in bronchiectasis?
are pneumococcus and H. influenzae
how do TB and histoplasmosis (fungus, AIDS) cause bronchiectasis?
Necrotizing inflammatory process
Weakens bronchus wall
How do measles and pertussis cause bronchiectasis?
Explosive coughing contribute to a dilatation of bronchial wall
Weakened by inflamm process
How does allergic aspergillosis contribute to bronchiectasis?
Ag-Ab complexes in bronchial wall
Lead to inflamm reaction
what is the management of bronchiectasis?
: aid sputum expectoriation and mucous drainage
b.If pseudomonas then need oral ciprofloxacin or iv ceftazidime
4.bronchodilators eg salbutamol nebs if have asthma, COPD, CF, ABPA
5.corticosteroids eg prednisolone for ABPA
6.surgery if LOCALISED disease or to control severe haemoptysis