Bronchiectasis

Bronchiectasis
CT scan showing bronchiectasis
Specialty	Pulmonology
Symptoms	Chronic cough, sputum production, shortness of breath
Complications	Respiratory failure, hemoptysis
Usual onset	Any age
Duration	Long term
Causes	Infections, immune system disorders, genetic conditions
Diagnostic method	CT scan, chest X-ray, sputum culture
Treatment	Antibiotics, bronchodilators, chest physiotherapy
Frequency	Varies globally

Bronchiectasis is a chronic condition characterized by the abnormal and permanent dilation of the bronchi, the large air passages leading from the trachea to the lungs. This condition results in impaired clearance of mucus, leading to frequent lung infections and inflammation.

Pathophysiology

Bronchiectasis occurs when there is damage to the bronchial walls, often due to repeated infections or inflammation. This damage leads to a vicious cycle of infection and further inflammation, as depicted in the

Vicious cycle of bronchiectasis pathogenesis

. The cycle involves:

• Infection causing inflammation
• Inflammation leading to further bronchial damage
• Impaired mucus clearance
• Increased susceptibility to further infections

Causes

The causes of bronchiectasis can be classified into several categories:

• Infectious causes: Previous severe lung infections such as pneumonia, tuberculosis, or whooping cough.
• Genetic conditions: Cystic fibrosis is a common genetic cause.
• Immune system disorders: Conditions like primary immunodeficiency or HIV/AIDS.
• Other causes: Aspiration of foreign bodies, allergic bronchopulmonary aspergillosis, and autoimmune diseases.

Symptoms

The main symptoms of bronchiectasis include:

• Chronic productive cough
• Production of large amounts of sputum
• Shortness of breath
• Wheezing
• Recurrent lung infections
• Fatigue

Diagnosis

Diagnosis of bronchiectasis typically involves:

• Clinical evaluation: Assessment of symptoms and medical history.
• Imaging studies: A CT scan is the gold standard for diagnosing bronchiectasis, showing the characteristic dilated bronchi. A chest X-ray may also be used.
• Sputum culture: To identify any bacterial infections.

Treatment

Treatment of bronchiectasis focuses on managing symptoms and preventing complications:

• Antibiotics: To treat and prevent infections.
• Bronchodilators: To help open the airways.
• Chest physiotherapy: Techniques to help clear mucus from the lungs.
• Surgery: In severe cases, surgical removal of affected lung areas may be considered.

Prognosis

The prognosis for individuals with bronchiectasis varies depending on the underlying cause and the effectiveness of treatment. With proper management, many people can lead relatively normal lives, although they may experience periodic exacerbations.

Also see

• Chronic obstructive pulmonary disease
• Cystic fibrosis
• Pulmonary rehabilitation
• Respiratory therapy