bronchiectasis
BRONCHIECTASIS
Bronchiectasis is an irreversible pathologic dilatation or ectasia of the bronchi due to repeated airway infection and inflammation.
It enhances susceptibility to bronchial infection and increases inflammatory reaction which causes further lung damage.
Classic symptoms of of bronchiectasis are cough with chronic sputum production along with recurring infective exacerbations and hemoptysis.

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
Mild
  • 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
Moderate
  • 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
Severe
  • 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
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