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Pulmonary and Critical Care Medicine

Bronchiectasis


Bronchiectasis is a chronic inflammation and dilation of the bronchi (airways or breathing tubes of the lungs) caused by damage or injury to the walls of the airways.

Causes
Bronchiectasis is usually the result of an infection or other condition that damages the walls of the airways or prevents the airways from clearing mucus. Severe pneumonia, whooping cough, measles, tuberculosis or fungal infections can injure the airways and lead to bronchiectasis.

Often, underlying conditions which affect the ability of the lungs to fight off infections may cause bronchiectasis. Such conditions include lowered immunity, improperly working cilia (called “dyskinetic cilia syndrome,” an abnormality of the micro-hairs which keep the lungs clear) and cystic fibrosis.

There are also localized forms of bronchiectasis, in which only one part of the lung has inflammation. In these cases, the cause is usually due to a local blockage in the breathing tubes or due to a previous injury to that part of the lung, such as a severe pneumonia.

Symptoms
Symptoms of bronchiectasis may include chronic cough and frequent production of green/yellow sputum, recurrent lung infections, bad breath and shortness of breath. It is also common for patients with generalized bronchiectasis to have chronic sinusitis, since the sinuses share the same kind of immune protection mechanisms as the lungs.

Diagnosis and Treatment
An evaluation for bronchiectasis will include a careful medical history and physical examination, followed by a review of all available X-rays, CT scans and medical records. Screening blood tests, analysis of the patient’s sputum and a CT scan of the lungs may also be performed.

Therapy is tailored to each case and is aimed at improving breathing, reducing the amount of sputum production and reducing the number and severity of lung infections.