bronchiectasis

• definition:

  • irreversible widening of bronchi
  • scarred inflamed airway
  • thick mucus presence
  • widen airway hinder clearance of mucus
  • mucus build up increase airway infection
• aetiology:

  • idiopathic: unknown origin account for 50% of case
  • cystic fibrosis: genetic condition leading to mucus build up
  • primary ciliary dyskinesia: cilia movement is affected
  • hypogammaglobulinemia: low level of antibody
  • inflammation: caused infection
  • CA bronchus: lung cancer or tumor in bronchus
  • pulmonary TB: lung infection cause by tuberculosis bacteria
  • fibrosis: scarring of lung tissue
• pathophysiology:

  1. damaged bronchial wall disrupt mucucilliary escalator
  2. bacteria coloniize in lung
  3. presence of bacteria trigger ineffective inflammatory response, result in cycle of chronic infection and inflammation
  4. inflammatory process damage muscular and elastic tissue, lead to dilation of airway
• mild: widened bronchi, normal branching airway is preserved

  severe: some bronchi constrict due to fibrosis, distal branch airway is blocked

  most severe: bronchi is dilated and blind ending, lung has cystic (large empty space within lung tissue)
• symptoms and sign

  • cough
  • purulent thick sputum
  • haemoptysis

  chronic stage:

  cough and purulent sputum/coarse crackle heard on auscultation of chest, indicate airway blockage or inflammation

  exacerbation:

  sign of infection like increased heart rate and body temperature/ breathlessness/ hypoxemia(low o2) hypercarbia(high co2)

  severe case:

  clubbing/ reduced ecercise tolerance
• special test:

  HRCT: show location of bronchial dilation and other structure change in airway

  sputum culture: identify specific bacteria causing infection

  lung function test: obstructive defect, test severity