Overview
As mentioned in the Introduction
section, bronchiectasis is the irreversible dilatation and destruction of the
bronchi. It results in airflow obstruction and impaired clearance of
secretions.
A detailed discussion about the incidence and prevalence of
bronchiectasis is in the Epidemiology
section.
The Pathophysiology section states there are 4 important factors
in the development of bronchiectasis, namely, chronic infection, airway
inflammation, impaired mucociliary clearance, and structural lung damage. How
these 4 factors interact is further discussed in this section.
As mentioned in the Etiology
section, there are various etiologies
that can precipitate or contribute to the development of bronchiectasis such as
primary infections, bronchial obstruction and recurrent aspiration, cystic
fibrosis, primary ciliary dyskinesia, allergic bronchopulmonary aspergillosis
(ABPA), young syndrome, etc.
Bronchiectasis_Disease SummaryHistory and Physical Examination
The Clinical Presentation section describes the classic manifestation
of bronchiectasis, which is cough with sputum production on most days
accompanied by a history of exacerbation. This section also divides the signs
and symptoms into mild, moderate, and severe.
The History section
emphasizes the importance of assessing symptom severity, frequency of
exacerbations, lung function, and review of comorbidities.
The general findings in patients with bronchiectasis are stated in the Physical Examination section. Other
physical findings are also discussed in this section.
Diagnosis
As mentioned in the Diagnosis and
Diagnostic Criteria section, the diagnosis of bronchiectasis is
based on clinical history of chronic cough with viscid sputum production,
presence of ≥1
exacerbations per year and characteristic CT scan findings.
Various diagnostic tests, such as sputum analysis and
pulmonary function tests are discussed in the Laboratory
Tests and Ancillaries section. Other diagnostic studies that can be done are
also discussed in this section.
The Imaging
section lists the different imaging modalities that can be done. Described here
as well are the characteristic findings.
Other conditions that should be ruled out in the diagnosis of bronchiectasis
are listed in the Differential
Diagnosis section.
Management
The Evaluation
section lists the predictors of exacerbations like prior history of
exacerbation, P aeruginosa infection, other respiratory comorbidities, and
even respiratory viral infections. The definition of acute exacerbation is also
found in this section.
The goals of therapy in bronchiectasis are discussed in the Principles of Therapy section. Discussed
in this section as well is the specific therapy or approach on the individual
causes of bronchiectasis.
The Pharmacological
Therapy section discusses in detail the different drugs that are
used bronchiectasis.
The Nonpharmacological section discusses other interventions such as
patient education, chest physiotherapy, pulmonary rehabilitation, bronchopulmonary
hygiene, and oxygen (O2) therapy.
Different surgical interventions lung resection and lung
transplantation are discussed in the Surgery section.
As described in the Follow-up
section, monitoring of bronchiectasis may include sputum culture, oxygen
saturation measurement (SpO2), and Medical Research Counsil (MRC)
dyspnea score. Depending on the severity, annual spirometry, body mass index (BMI)
measurement, and computed tomography (CT) scan may also be done.
