Resp History

Bronchiectasis History-Taking



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    • Diagnosis - when the diagnosis was made, cause
    • Exercise tolerance
    • Frequency of exacerbations
    • Colonisation - bacteria that have been isolated in the past (e.g. Moraxella, Haemophilus, Pseudomonas, Staphylococcus aureus, Burkholderia cepacia, Mycobacterium)
    • Complications - infections, haemorrhage, cor pulmonale
    • Management - sputum clearance strategies, long-term antibiotics
    • Causes of Bronchiectasis

    • Congenital

    • Cystic fibrosis
    • Primary ciliary dyskinesia (e.g. Kartegener’s syndrome)
    • Hypogammaglobulinaemia
    • Acquired

    • Recurrent pneumonia (e.g. in the setting of immunosuppression) - bacterial, tuberculous, fungal
    • Chronic obstructive pulmonary disease (COPD)
    • Allergic bronchopulmonary aspergillosis (ABPA)
    • Autoimmune diseases - rheumatoid arthritis, Sjogren’s syndrome, ulcerative colitis
    • Chronic aspiration (e.g. secondary to gastroesophageal reflux)
    • Airway foreign body


    • Complications of Bronchiectasis

    • Acute exacerbations
    • Pulmonary haemorrhage
    • Pneumothorax
    • Empyema
    • Lung abscess
    • Cor pulmonale


    • Management Strategy

    • Treat the underlying cause
    • Sputum clearance - bronchodilators, mucolytics, hypertonic saline, physiotherapy, postural drainage
    • Reduce inflammation - using macrolides (azithromycin)
    • Manage infection - monitor for colonisation, consider antimicrobial prophylaxis
    • Vaccinations - influenza, pneumococcus
    • Nutritional support
    • Home oxygen
    • Lung transplant
Last updated on May 1st, 2019
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