BRONCHIECTASIS

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Lungs

Respiratory system

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Definition

Bronchiectasis is destruction and widening of the large airways.

• If the condition is present at birth, it is called congenital bronchiectasis.
• If it develops later in life, it is called acquired bronchiectasis.

Alternative Names

Acquired bronchiectasis; Congenital bronchiectasis

Causes, incidence, and risk factors

Bronchiectasis is often caused by recurrent inflammation or infection of the airways. It most often begins in childhood as a complication from infection or inhaling a foreign object.

Cystic fibrosis causes about half of all bronchiectasis in the United States. Recurrent, severe lung infections (pneumonia, tuberculosis, fungal infections), abnormal lung defenses, and obstruction of the airway by a foreign body or tumor are some of the risk factors.

The condition can also be caused by routinely breathing in food particles while eating.

Symptoms

Symptoms often develop gradually, and may occur months or years after the event that causes the bronchiectasis.

They may include:

• Bluish skin color
• Breath odor
• Chronic cough with large amounts of foul-smelling sputum
• Clubbing of fingers
• Coughing up blood
• Cough that gets worse when lying on one side
• Fatigue
• Paleness
• Shortness of breath that gets worse with exercise
• Weight loss
• Wheezing

Signs and tests

When listening to the chest with a stethoscope, the doctor may hear small clicking, bubbling, wheezing, rattling, or other sounds, usually in the lower lobes of the lungs.

Tests may include:

• Aspergillosis precipitin test (to check for signs of the aspergillosis fungus)
• Chest x-ray
• Chest CT
• Sputum culture
• Complete blood count (CBC)
• PPD skin test to check for a prior tuberculosis infection
• Serum immunoglobulin electrophoresis
• Sweat test or other cystic fibrosis testing

Reviewer Info: Benjamin Medoff, MD, Assistant Professor of Medicine, Harvard Medical School, Pulmonary and Critical Care Unit, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 09/24/2008