Bronchiectasis
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}} Bronchiectasis is a chronic inflammatory or degenerative condition of one or more bronchi or bronchioles of the lungs marked by dilatation and loss of elasticity of the walls. This results in airflow obstruction and impaired clearance of secretions. People with bronchiectasis produce large amounts of sputum.
Bronchiectasis was first described by René Laënnec in 1819 and later detailed by Sir William Osler in the late 1800s.
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Diagnosis
The diagnosis of bronchiectasis is based on a clinical history of daily viscous sputum production and characteristic CT scan findings (such as multiple cysts near the bottom of the lung).
A "Tree in bud" pattern may be seen on CT scans.
Treatment
Treatment of bronchiectasis is aimed at controlling infections and bronchial secretions, relieving airway obstruction, and preventing complications. This includes fighting infections with antibiotics and eliminating the fluid with postural drainage and chest physiotherapy.
A classic bacterium that is seen in people with bronchiectasis is Pseudomonas aeruginosa, which is notoriously hard to eradicate. Repeated infections of the airways by this bacterium can lead to colonization of the bronchi by this organism which predisposes such people to Pseudomonal pneumonias, which requires special antibiotics to treat. It is controversial whether to give those with bronchiectasis daily antibiotics to prevent infection from happening or whether to treat each time they become ill.
Causes
The most common cause worldwide is scarring from tuberculosis. In the United States the most common cause is probably cystic fibrosis. Chronic tobacco use (smoking) can also lead to emphysema in 20% of smokers, which can lead to chronic bronchitis (productive cough more than 3 months in 3 consecutive years), which in turn can lead to scarring of the bronchi that develops into bronchiectasis. Adults can have inherited immunodeficiencies that present as recurrent lung infections that ultimately lead to bronchiectasis.
It is characteristic in a number of conditions, particularly Kartagener syndrome.
External links
Chronic Bronchitis is defined as symptoms for 3 months during 2 years.Template:Disease-stub