Bronchiectasis

causes:

1- congenital syndromes

• cystic fibrosis

• ciliary dysfunction syndromes

• hypogammaglobulinaemia

• Yellow nail syndrome

2- airway obstruction

• foreign body/neoplasm/stricture

3- Infection

• suppurative pneumonae

• Pul TB

• ABBA

• severe bacterial infection in childhood

Features:

• Chronic productive cough

→ sputum copious,persistantly purulent

• Fever

• Malaise

• Haemoptysis→ can be torrential

• Wt loss

• Clubbing

o/e:Low pitch leathery inspiratory and expiratory crackles or coarse creps

Investigations:

1. Sputum C/S

2. CXR

3. CT chest

4. Spirometry

5. Bronchoscopy

• Assessment of ciliary function

• Serum immunoglobulins

• Sweat test for CF

• Skin prick test for ABBA

CXR:

• Cystic shadows

• Fluid level

• Thickened bronchial wall

• collapse

CT

• Definitive diagnosis

Management

1. Postural drainage twice daily

2. Antibiotics guided by the C/S

   1. e.g cipro,ceftazidine

3. Bronchodilators

4. Surgical treatment

Complications:

• Haemoptysis

• Respiratory failure

• Cor pulmonale

• Pneumothorax

• Brain abscess

• Amyloidosis

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