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    Bronchiectasis

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    Eliza Butt
    Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi. It typically affects older individuals and more women than men. Common causes include impaired immune defenses, infections, and other inflammatory conditions. Symptoms include chronic cough, sputum production, and recurrent lung infections. Diagnosis involves sputum culture, chest imaging such as CT scan. Treatment focuses on airway clearance, controlling infections with antibiotics, and addressing the underlying cause if possible.

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    Bronchiectasis

    Uploaded by

    Eliza Butt
    10 views21 pages
    Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi. It typically affects older individuals and more women than men. Common causes include impaired immune defenses, infections, and other inflammatory conditions. Symptoms include chronic cough, sputum production, and recurrent lung infections. Diagnosis involves sputum culture, chest imaging such as CT scan. Treatment focuses on airway clearance, controlling infections with antibiotics, and addressing the underlying cause if possible.

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    Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi. It typically affects older individuals and more women than men. Common causes include impaired immune defenses, infections, and other inflammatory conditions. Symptoms include chronic cough, sputum production, and recurrent lung infections. Diagnosis involves sputum culture, chest imaging such as CT scan. Treatment focuses on airway clearance, controlling infections with antibiotics, and addressing the underlying cause if possible.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    10 views21 pages

    Bronchiectasis

    Uploaded by

    Eliza Butt
    Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi. It typically affects older individuals and more women than men. Common causes include impaired immune defenses, infections, and other inflammatory conditions. Symptoms include chronic cough, sputum production, and recurrent lung infections. Diagnosis involves sputum culture, chest imaging such as CT scan. Treatment focuses on airway clearance, controlling infections with antibiotics, and addressing the underlying cause if possible.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 21

    BRONCHIECTASIS

    Dr Ramish Saleem, PT
    DPT(SMC)
    MS-OMPT(RIU)
    BRONCHIECTASIS
    Definition:
    • Abnormal and permanent dilation of bronchi.
    • Focal or diffuse distribution.
    • It is a disorder that typically affects older individuals.
    • approximately 2/3 of patients are women.
    • It is usually acquired but may result from an underlying
    genetic or congenital defect of airway defences.
    • Clinical consequences –chronic and recurrent
    infection and Pooling of secretions in dilated airways.
    PATTERNS OF BRONCHIECTASIS
    Three different patterns of bronchiectasis have been
    described
     Cylindrical bronchiectasis: the involved bronchi appear
    uniformly dilated.
     Varicose bronchiectasis: the affected bronchi have an
    irregular or beaded pattern of dilatation resembling
    varicose veins.
     Saccular (cystic) bronchiectasis: the bronchi have a
    ballooned appearance at the periphery, ending in blind
    sacs.
    BRONCHIECTASIS
    AETIOLOGY : IMPAIRED HOST
    DEFENCE
    • Local causes: Endobronchial obstruction
    • Generalised impairment:
    – 1. Immunoglobulin deficiency
    – 2. Primary ciliary disorders
    – 3. Cystic fibrosis
    AETIOLOGY : NON-INFECTIOUS
    • Toxins or toxic substances ; gastric contents
    • Immune responses,
    • Inflammatory diseases: ulcerative colitis,
    rheumatoid arthritis, Sjögren syndrome
    (chronic autoimmune disease in which the
    body's white blood cells destroy the exocrine glands,
    specifically the salivary and lacrimal glands, that
    produce saliva and tears.)
    • -1-Antitrypsin deficiency
    Clinical features of bronchiectasis
    Due to accumulation of pus in dilated
    bronchi
    • Chronic productive cough usually worse in mornings and
    often brought on by changes of posture.
    • Sputum often copious and persistently purulent in
    advanced disease.
    • Halitosis is a common accompanying feature
    • SOB
    Due to inflammatory changes in lung and pleura
    surrounding dilated bronchi

    • Fever, malaise and increased cough and


    sputum volume when spread of infection
    causes pneumonia, which may be associated
    with pleurisy.

    • Recurrent pleurisy in the same site often


    occurs in bronchiectasis
    • Haemoptysis
    Can be slight or massive and is often recurrent. Usually
    associated with purulent sputum or an increase in sputum
    purulence.
    Can, however, be the only symptom in so-called 'dry
    bronchiectasis.'

    • General health
    When disease is extensive and sputum persistently
    purulent a decline in general health occurs with weight
    loss, anorexia, low-grade fever, and failure to thrive in
    children. In these patients digital clubbing is common.
    Physical signs
    • may be unilateral or bilateral.
    • If the bronchiectatic airways do not contain secretions and there is
    no associated lobar collapse, there are no abnormal physical signs.
    • When there are large amounts of sputum in the bronchiectatic
    spaces numerous coarse crackles may be heard over the affected
    areas.
    • When collapse is present the character of the physical signs depends
    on whether or not the proximal bronchus supplying the collapsed lobe
    is patent (breath sounds are diminished if the airway is obstructed).
    • Advanced disease may lead to scarring with associated overlying
    bronchial breathing.
    Bronchiectasis
    • If wide spread 
    – Dyspnea
    • Clubbing of the
    fingers
    •  h pulmonary
    blood pressure 
    Cor pulmonale
    When to suspect
    bronchiectasis?
    • Chronic cough, sputum
    • Hemoptysis
    • Coarse rales
    • Persistent respiratory
    symptoms
    • Recurrent pneumonia
    • Progressive obstructive lung
    disease
    • Clubbing
    Investigations
    • Bacteriological and mycological examination of sputum
    • In addition to common respiratory pathogens, sputum culture may
    reveal Pseudomonas aeruginosa, fungi such as Aspergillus and
    various Mycobacteria.
    • Frequent cultures are necessary to ensure appropriate treatment of
    resistant organisms.

    • Radiological examination Bronchiectasis, unless very gross, is not


    usually apparent on a chest X-ray.
    • In advanced disease, thickened airway walls, cystic bronchiectatic
    spaces, and associated areas of pneumonic consolidation or collapse
    may be visible.
    • CT scan of chest is much more sensitive, and shows thickened dilated
    airways
    Fig 11 Dilated
    airways of
    bronchiectasis in
    the right lower
    lobe.
    MEDICAL TREATMENT
    4 Goals:
    1. Eliminate cause
    2. Improve tracheo bronchial clearance
    3. Control infection
    4. Reverse airflow obstruction
    Medical treatment
    • Liberal use of antibiotics helps control infection.
    • Patients are given a store of antibiotics to be taken at the first sign
    of colour change in their sputum.
    • For patients who deteriorate every winter, regular antibiotics can
    be taken in the cold months.
    • Antibiotics do not control the persistent inflammation that may be
    progressively destroying the airways but inhaled steroids can assist
    this and reduce the volume of sputum.
    • Bronchodilators are used if there is demonstrable hyperreactivity.
    • Surgical resection of non-perfused lung may be indicated for
    localized and disabling disease.
    • Occasionally, transplantation is possible in late-stage disease.
    • Sometimes the cause of the disorder might be treatable, e.g.topical
    steroids for rhinosinusitis to prevent mucus sliding from the back of
    the nose into the lung.
    Physical therapy
    • Bronchiectasis reduces mucociliary clearance and patients
    need education in sputum clearance to compensate for this.
    • A daily programme is required that is sufficient to eliminate
    coughing in between clearance sessions.
    • Hydration, an exercise programme and ACBT are often
    adequate but other measures may be required, sometimes
    including postural drainage.
    • Patients should be discouraged from coughing until they are
    ready to expectorate in order to minimize fatigue and cough-
    related stress incontinence.
    • Much encouragement is needed to help patients set up a
    life-long programme that is effective and suited to their
    lifestyle.
    Prevention

    • As bronchiectasis commonly starts in childhood


    following measles, whooping cough or a primary
    tuberculous infection, it is essential that these
    conditions receive adequate prophylaxis and
    treatment.
    • The early recognition and treatment of bronchial
    obstruction are also particularly important.

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