Bronchiectesis

Bronchiectesis is an obstructive disease caused by chronic infection of the bronchial tree. This causes permanent dilatation of the airways and leads to inflammation. In the UK it is a a result of Cystic fibrosis

Bronchiectesis is not a disease in itself but more of a complications of other conditions.

Conditions include: CF, whooping cough, ciliary dysfunction syndromes, primary hypogammaglobuminaemia, congenital abnormalities, TB

Symptoms
Symptoms include, chronic cough, production of large amounts of foul smelling sputum which may contain flecks of blood. The cough is usually worse in the mornings and may be brought on by postural changes
 * Finger clubbing
 * Recurrent RTI
 * Fever/Malaise
 * Haemoptysis

In advanced disease there is a general decline in health, including weight loss, anorexia, low-grade fever and FTT

Signs
uni/bilateral
 * Course crackles over areas with alot of sputum
 * Absence of breath sounds- possible collapse
 * Reduced or absent breath sounds at areas distal to places of obstruction

Investigations
Sputum sample- common organisms include: H.influenza, strep pneumonia, staph aurea, pseudomonas aerugionas, aspergillus fumigates, TB

CXR most cases will be normal (in advances, thickened airway walls, cystic spaces, consolidation/collapse)

CT-(thickened and dilated airways, classic signet ring appearance)

Genotypiing/sweat electrolyte test/ measure mucociliary clearnace

Management
Same as CF