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Definition
- An irreversible dilatation & destruction of the bronchi
- Results in airflow obstruction & impaired clearance of secretions
- Enhances susceptibility to bronchial infection & increases inflammatory reaction which causes further lung damage
Signs and Symptoms
- Classic symptoms of bronchiectasis are cough w/ chronic sputum production; along w/ recurring infective exacerbations & hemoptysis
- Rattly cough producing sputum after colds only
- Sputum production of <10 mL/day
- Change of position may cause sputum production
- May cause mild hemoptysis
- Well patient
- Constant rattly cough
- Sputum production of 10-150 mL/day
- Sputum production most of the time
- Occasional hemoptysis
- May have foul smelling breath
- Usually well patient
- Production of large volumes of sputum
- Sputum production of >150 mL/day
- Occasional pleural pain & hemoptysis
- Usually unwell patient
- May develop resp failure
Symptoms of Exacerbation
- Recognizing acute exacerbation generally depends upon symptomatic changes rather than any specific lab result
- Identification of acute exacerbation may be difficult since the onset may be gradual w/ sputum volume increasing slowly over mth
- Acute bacterial infections are usually indicated by increased sputum production w/ enhanced viscidity, often w/ lassitude, shortness of breath, & pleuritic chest pain
- Fever & chills are generally absent & chest x-ray rarely shows new infiltrates
