Bronchiectasis is defined by localized, irreversible dilation of the bronchi caused by destruction of the bronchi walls. The damaged bronchi are inflamed and collapsible, resulting in impaired clearance of secretions
What are the symptoms? Frequent respiratory infections and production of green/yellow sputum is the most prevalent symptom. Dyspnea, wheezing and bad breath are other common symptoms. What are the causes? Congenital and acquired causes, that predispose patients to chest infections, are both responsible for the developing of bronchiectasis. Acquired Immune Deficiency Syndrome (AIDS), tuberculosis, inflammatory bowel disease (ulcerative colitis and Crohn’s disease), allergic bronchopulmonary Aspergillosis, rheumatoid arthritis and common respiratory infections are all culprit acquired conditions. Congenital causes include, among others, Kartagener syndrome, cystic fibrosis, Young’s syndrome, alpha 1-antitrypsin deficiency and primary immunodeficiencies. Prevention How is the diagnosis made?The clinical suspicion set from the aforementioned symptoms is usually confirmed from the findings in high-resolution CT. Usual findings are the “tree-in-bud” pattern, cysts with definable borders and multiple small nodules.
How can we prevent disease? Immunization against measles, pertussis and other causes of childhood’s acute respiratory infections is the first step. In patients with predispose conditions vaccination against pneumonia and influenza is also necessary. Is there a treatment? Since bronchiectasis is a disease with anatomical damage, it is a permanent condition. Treatment includes measures for controlling infections (eg vaccination) and enhance bronchial clearance. Prolonged usage of antibiotics (either orally or using nebulizers) is also indicated in some conditions. Inhaled steroid therapy to decrease inflammation is also commonly used.