Pulmonology Book

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Bronchiectasis

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  1. Epidemiology
    1. Onset: middle aged
  2. Pathophysiology
    1. Chronic inflammatory or infectious pulmonary process
    2. Results in multiple dilatations of small bronchi
    3. Bronchi exude pustular discharge
  3. Causes
    1. Bronchial obstruction
    2. Recurrent or severe pulmonary infections
      1. Necrotizing pulmonary infection
      2. Pulmonary abscess
      3. Tuberculosis
      4. Aspergillosis
      5. Measles
      6. Pertussis
      7. RSV Bronchiolitis
    3. Hypergammaglobulinemia
    4. Dyskinetic cilia syndrome
    5. Kartagener's Syndrome
    6. Alpha-1 Antitrypsin Deficiency
    7. Cystic Fibrosis
    8. Inhalation of noxious chemicals
  4. Symptoms
    1. Productive cough
      1. Copious Sputum (200-500 ml/day)
      2. Sputum thick, mucopurulent and foul-smelling
      3. Hemoptysis
    2. Wheezing
    3. Dyspnea
    4. Halitosis
    5. Fatigue
    6. Weight loss to Emaciation
  5. Signs
    1. Lung auscultation
      1. Coarse or moist crackles
      2. Rales and Rhonchi
      3. Wheezing
      4. Diminished breath sounds
    2. Cyanosis
    3. Digital Clubbing
  6. Differential Diagnosis
    1. Chronic Obstructive Pulmonary Disease (COPD)
    2. Cystic Fibrosis
    3. Pulmonary Tuberculosis
  7. Labs: Sputum
    1. Sputum forms layers on standing
      1. Top: Mucus
      2. Middle: Clear fluid
      3. Bottom: Pus
    2. Sputum Culture not diagnostic (mixture of organisms)
    3. Fungal Culture
  8. Radiology: Chest XRay
    1. Often normal, even in advanced disease
    2. May show increased density at lung bases
    3. Airways may be dilated and thickened ("ring shadow")
    4. Atelectasis may be present
  9. Diagnosis
    1. Pulmonary Function Tests
      1. Airflow obstruction with reversible component
    2. Diagnostic postural drainage
      1. Patient lies prone in Trendelenburg for 5-15 minutes
      2. Head over edge of table, and pan on floor
      3. Patient coughs several times and pus rolls into pan
    3. Bronchograms with opaque medium
    4. Bronchoscopy
    5. Chest CT
  10. Course
    1. Chronic progressive with exacerbations

Bronchiectasis (C0006267)

Definition (MSH)Persistent abnormal dilatation of the bronchi.
Definition (CSP)persistent abnormal dilatation of the bronchi.
ConceptsDisease or Syndrome (T047)
ICD9494
MSHD001987
EnglishBronchiectases, Bronchiectasis
Spanishbronquiectasia
Parent ConceptsBronchial Diseases (C0006261), Infection (C0021311), Lung diseases (C0024115), Bronchus and Bronchiole (C0549578), AIRWAYS DISEASE (C0699949), CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ALLIED CONDITIONS (C0178278), Bronchiectasis (C0006267), Duplicate concept (C1274013)
SourcesCOSTAR, CSP, CST, DXP, ICD9CM, LCH, MSH, NDFRT, OMIM, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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