Bronchiectasis

Bronchiectasis

Definition:

Bronchiectasis is a dilatation of the medium sized bronchi with destruction of bronchial elastic and muscular elements.It is destruction and widening of the large airways. A person may be born with it (congenital bronchiectasis) or may develop it later in life.


Cylindrical or tubular bronchiectasis is characterized by dilated airways alone and is sometimes seen as a residual effect of pneumonia; varicose bronchiectasis (so named because its appearance is similar to that of varicose veins) is characterized by focal constrictive areas along the dilated airways that result from defects in the bronchial wall; and saccular or cystic bronchiectasis is characterized by progressive dilatation of the airways, which end in large cysts, saccules,or grape-like clusters (this finding is always indicative of the most severe form of bronchiectasis).

Cystic fibrosis causes about 50% of all bronchiectasis in the United States today. Recurrent, severe lung infections (pneumonia, tuberculosis, fungal infections), abnormal lung defenses, and obstruction of the airway by a foreign body or tumor are some of the predisposing factors. It can also be caused by routinely breathing in food particles while eating.

A heavy smoking habit probably also contributed to this gaunt appearance. Perhaps due to this childhood respiratory illnesses may develop bronchiectasis, a condition characterized by perpetually dilated bronchi and fits of coughing.

The risk of dying due to bronchiectasis, usually a rare lung disease, is 46 times higher than normal if the child's mother also drank the arsenic-contaminated water while pregnant, according to the study. These findings provide some of the first human evidence that fetal or early childhood exposure to any toxic substance can result in markedly increased disease rates in adults.

Etiology:

Clinical Features:

Symptoms:

Signs:

On general examination-Emaciation, cyanosis and clubbing-of fingers seen in advanced cases.
On chest examination:

Investigations:

A. Blood :

B. Sputum:
Smears and cultures to rule out active tuberculosis.

C. X-ray chest:
Plain X-ray will show -Increased pulmonary markings at the lung bases together with multiple Radiolucencies (honey comb appearance) strongly suggestive of diagnosis.

D. Bronchography : It is the most diagnostic investigation.

Differential diagnosis:

Delayed diagnosis of an endobronchial foreign body may result in bronchiectasis, atelectasis, abscess formation, chronic pneumonia, bronchial stenosis, empyema, and fistula formation. In a child with chronic cough and atelectasis, bronchial obstruction from a foreign body should always be considered as a possible diagnosis. Wheezing and hemoptysis are frequent symptoms.

1. Chronic bronchitis :

2. Tuberculosis

3. Lung abscess :

The main finding, bronchiectasis may warrant the consideration of anatomical, infectious, and other causes. The replacement of bronchography by high-resolution computed tomography (CT) as a definitive imaging tool; and the similarities and differences between bronchiectasis and cystic fibrosis in terms of clinical features and management strategies.

Complications of Bronchiectasis:

Management and treatment:

Treatment of bronchiectasis is aimed at controlling infections and bronchial secretions, relieving airway obstruction, and preventing complications. This includes prolonged usage of antibiotics to prevent detrimental infections, as well as eliminating accumulated fluid with postural drainage and chest physiotherapy. Surgery may also be used to treat localized bronchiectasis, removing obstructions that could cause progression of the disease.

Comments

I've had bronchitis since

I've had bronchitis since childhood, at 8 I'd had a left lobectomy. I have really bad sinuses and lost a lot of my hearing. In my thirties got rheumatoid arthritis. The point of my leaving something here is I now have the bacteria pseudonymous and I'm feeling rough all the time. I wondered now I'm 64 years of age what is the likely prognosis? I get very tired and the infections can't be killed off. I've been in hospital twice for intro-venous antibiotics to no avail.

My husband has had a CT scan

My husband has had a CT scan which shows a mild tubular bronchiectasis of the left lung base, in association with mild adjacent inflammtory change. What can be given to help with this condition?

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