Clinical Presentation
Signs and Symptoms
The classic clinical manifestations of bronchiectasis include cough with sputum production on most days and a history of exacerbations. It must be noted that some patients may complain of dyspnea, wheezing, and pleuritic chest pain.
Mild
- Rattly cough producing sputum after colds only
- Sputum production of <10 mL/day
- Chang 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 and hemoptysis
- Usually well patient
- May develop respiratory failure
Tiền sử bệnh
History taking should include assessment of symptom severity, frequency of exacerbations, lung function, and review of comorbidities.
Khám thực thể
General findings in patients with bronchiectasis include cyanosis, plethora, wasting, weight loss, and finger clubbing. Physical findings are non-specific but persistent coarse crackles over any part of the lungs suggest bronchiectasis; wheezing may also be present. In advanced disease, cor pulmonale may be observed. Nasal polyps and sinusitis may also be present.
Bronchiectasis_Initial AssesmentDiagnosis or Diagnostic Criteria
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. A rare variant of bronchiectasis exists, which manifests with episodic hemoptysis with no sputum production (usually a sequela of tuberculosis [TB]). Once diagnosis is established, underlying etiologies that may have precipitated or caused the bronchiectasis should be investigated.