Bronchiectasis - Revision history

Rossdonaldson1: /* Evaluation */

2024-04-24T20:55:42Z

Evaluation

← Older revision		Revision as of 20:55, 24 April 2024
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	==Evaluation==		==Evaluation==
	[[File:Chest X-ray of hyperinflated lung with bronchiectasis at the right upper lobe.jpg\|thumb\|Chest X-ray of hyperinflated lung with bronchiectasis at the right upper lobe.]]		[[File:Chest X-ray of hyperinflated lung with bronchiectasis at the right upper lobe.jpg\|thumb\|Chest X-ray of hyperinflated lung with bronchiectasis at the right upper lobe.]]
			[[File:Bronquiectasia.jpeg\|thumb\|Bronchiectasis on CT.]]
	*Evaluate for alternative causes of symptoms		*Evaluate for alternative causes of symptoms
	*[[CXR]]		*[[CXR]]

Rossdonaldson1: /* Background */

2024-04-24T20:52:37Z

Background

← Older revision		Revision as of 20:52, 24 April 2024
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	PA - Branch of Arteria pulm.		PA - Branch of Arteria pulm.
	PV - Branch of Vena pulm.]]		PV - Branch of Vena pulm.]]
	[[File:Bronchiectasis ~~NHLBI~~.jpg\|thumb]]		[[File:Bronchiectasis Normal vs Affected Airway.jpg\|thumb\|Bronchiectasis normal vs affected airway.]]
	[[File:Bronchiectasis Vicious Cycle Pathogenesis.png\|thumb\|Bronchiectasis pathogenic cycle.]]		[[File:Bronchiectasis Vicious Cycle Pathogenesis.png\|thumb\|Bronchiectasis pathogenic cycle.]]
	*Uncommon disease caused by chronic infection and inflammation		*Uncommon disease caused by chronic infection and inflammation

Rossdonaldson1: /* Background */

2024-04-24T20:49:52Z

Background

← Older revision		Revision as of 20:49, 24 April 2024
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	PV - Branch of Vena pulm.]]		PV - Branch of Vena pulm.]]
	[[File:Bronchiectasis NHLBI.jpg\|thumb]]		[[File:Bronchiectasis NHLBI.jpg\|thumb]]
			[[File:Bronchiectasis Vicious Cycle Pathogenesis.png\|thumb\|Bronchiectasis pathogenic cycle.]]
	*Uncommon disease caused by chronic infection and inflammation		*Uncommon disease caused by chronic infection and inflammation
	*Characterized by dilation and destruction of larger bronchi		*Characterized by dilation and destruction of larger bronchi

Rossdonaldson1: /* Disposition */

2024-04-24T20:46:30Z

Disposition

← Older revision		Revision as of 20:46, 24 April 2024
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	==Disposition==		==Disposition==
			*Patients with CF and new hypoxia/significant symptoms are commonly admitted

	==See Also==		==See Also==

Rossdonaldson1: /* Evaluation */

2024-04-24T20:45:29Z

Evaluation

← Older revision		Revision as of 20:45, 24 April 2024
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	==Evaluation==		==Evaluation==
			[[File:Chest X-ray of hyperinflated lung with bronchiectasis at the right upper lobe.jpg\|thumb\|Chest X-ray of hyperinflated lung with bronchiectasis at the right upper lobe.]]
	*Evaluate for alternative causes of symptoms		*Evaluate for alternative causes of symptoms
	*[[CXR]]		*[[CXR]]

Rossdonaldson1: /* Background */

2024-04-24T20:41:29Z

Background

← Older revision		Revision as of 20:41, 24 April 2024
Line 11:		Line 11:
	PA - Branch of Arteria pulm.		PA - Branch of Arteria pulm.
	PV - Branch of Vena pulm.]]		PV - Branch of Vena pulm.]]
			[[File:Bronchiectasis NHLBI.jpg\|thumb]]
	*Uncommon disease caused by chronic infection and inflammation		*Uncommon disease caused by chronic infection and inflammation
	*Characterized by dilation and destruction of larger bronchi		*Characterized by dilation and destruction of larger bronchi

Rossdonaldson1: /* Background */

2024-04-24T20:39:20Z

Background

@@ Line 1: / Line 1: @@
 ==Background==
 *Uncommon disease caused by chronic infection and inflammation
 *Characterized by dilation and destruction of larger bronchi

Rossdonaldson1: /* Clinical Features */

2024-04-10T16:29:24Z

Clinical Features

← Older revision		Revision as of 16:29, 10 April 2024
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	==Clinical Features==		==Clinical Features==
			[[File:Dedos con acropaquia.jpg\|thumb\|An example of [[clubbing]].]]
	*Chronic [[cough]] productive of thick, often purulent sputum		*Chronic [[cough]] productive of thick, often purulent sputum
	*[[Dyspnea]]		*[[Dyspnea]]
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	*+/- [[hemoptysis]], due to airway neovascularization, can be massive		*+/- [[hemoptysis]], due to airway neovascularization, can be massive
	*If advanced;		*If advanced;
	**[[Hypoxia]], clubbing		**[[Hypoxia]], [[clubbing]]
	**[[Pulmonary hypertension]], right-sided [[heart failure]]		**[[Pulmonary hypertension]], right-sided [[heart failure]]
	*Acute exacerbation results from new/worsened infection, may have [[fever]] and constitutional symptoms		*Acute exacerbation results from new/worsened infection, may have [[fever]] and constitutional symptoms

ClaireLewis: /* Management */

2019-10-11T15:34:57Z

Management

← Older revision		Revision as of 15:34, 11 October 2019
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	*Antibiotics		*Antibiotics
	**Some patients may be on chronic [[macrolides]] or other antibiotics		**Some patients may be on chronic [[macrolides]] or other antibiotics
	**If no CF and no prior culture data, treat against H. influenzae, M. catarrhalis, S. aureus, and S. pneumoniae (e.g. [[amoxicillin/clavulanate]], [[azithromycin]], [[TMP-SMX]])		**If no CF and no prior culture data, treat against H. influenzae, M. catarrhalis, S. aureus, and S. pneumoniae (e.g. [[amoxicillin-clavulanate]], [[azithromycin]], [[TMP-SMX]])
	**If CF or more severe exacerbation, broaden antibiotics, knowing that many CF patients develop highly resistant polymicrobial infections and likely require multiple antibiotics (e.g. [[tobramycin]], [[aztreonam]], [[Zosyn]], [[cefepime]]		**If CF or more severe exacerbation, broaden antibiotics, knowing that many CF patients develop highly resistant polymicrobial infections and likely require multiple antibiotics (e.g. [[tobramycin]], [[aztreonam]], [[Zosyn]], [[cefepime]]
	**Consider inhaled antibiotics to reduce sputum bacterial load		**Consider inhaled antibiotics to reduce sputum bacterial load
	*Treat massive [[hemoptysis]]		*Treat massive [[hemoptysis]]


	==Disposition==		==Disposition==

ClaireLewis: Created page with "==Background== Uncommon disease caused by chronic infection and inflammation Characterized by dilation and destruction of larger bronchi **Mucus build up attracts bacteria/m..."

2019-08-24T20:24:13Z

Created page with "==Background== *Uncommon disease caused by chronic infection and inflammation *Characterized by dilation and destruction of larger bronchi **Mucus build up attracts bacteria/m..."

New page

==Background==
*Uncommon disease caused by chronic infection and inflammation
*Characterized by dilation and destruction of larger bronchi
**Mucus build up attracts bacteria/microbes--> bacteria multiply--> additional lung infection/inflammation-->more airway damage--> over time, enlarged/widened airways make it harder to breath and clear mucus
*Commonly caused by [[cystic fibrosis]], immune defects, recurrent [[pneumonia]]s, or (less commonly), congenital or idiopathic

==Clinical Features==
*Chronic [[cough]] productive of thick, often purulent sputum
*[[Dyspnea]]
*Crackles/rhonchi, [[wheezing]]
*+/- pleuritic [[chest pain]]
*+/- [[hemoptysis]], due to airway neovascularization, can be massive
*If advanced;
**[[Hypoxia]], clubbing
**[[Pulmonary hypertension]], right-sided [[heart failure]]
*Acute exacerbation results from new/worsened infection, may have [[fever]] and constitutional symptoms

==Differential Diagnosis==
{{SOB DDX}}

==Evaluation==
*Evaluate for alternative causes of symptoms
*[[CXR]]
**Thickening of airway walls and/or airway dilation
**Linear perihilar densities, indistinctness of central pulmonary arteries
**"Tram-track sign"; thickened, dilated airways perpendicular to x-ray beam
**Elongated, tubular opacities due to mucus plugs
*CT chest
**Sensitive and specific
**Airway dilation, signet ring sign (thickened, dilated airway adjacent to smaller artery
**Lack of normal bronchial tapering-->visible medium bronchi extending out closer to pleura
**"Tram-track" sign
*Infectious workup
**Consider sputum for [[TB]]
*Diagnosis of cause generally outside ED scope but may include workup for [[cystic fibrosis]], immunodeficiency, ciliary dysmotility

==Management==
*[[Bronchodilators]]
*Supplemental [[O2]] PRN
*Chest PT
*Mucolytics (e.g. [[NAC]] mucomyst, hypertonic saline nebs)
*Antibiotics
**Some patients may be on chronic [[macrolides]] or other antibiotics
**If no CF and no prior culture data, treat against H. influenzae, M. catarrhalis, S. aureus, and S. pneumoniae (e.g. [[amoxicillin/clavulanate]], [[azithromycin]], [[TMP-SMX]])
**If CF or more severe exacerbation, broaden antibiotics, knowing that many CF patients develop highly resistant polymicrobial infections and likely require multiple antibiotics (e.g. [[tobramycin]], [[aztreonam]], [[Zosyn]], [[cefepime]]
**Consider inhaled antibiotics to reduce sputum bacterial load
*Treat massive [[hemoptysis]]

==Disposition==

==See Also==

==External Links==

==References==
<references/>
[[Category:Pulmonary]]

Bronchiectasis - Revision history

Rossdonaldson1: /* Evaluation */

Rossdonaldson1: /* Background */

Rossdonaldson1: /* Background */

Rossdonaldson1: /* Disposition */

Rossdonaldson1: /* Evaluation */

Rossdonaldson1: /* Background */

Rossdonaldson1: /* Background */

Rossdonaldson1: /* Clinical Features */

ClaireLewis: /* Management */

ClaireLewis: Created page with "==Background== *Uncommon disease caused by chronic infection and inflammation *Characterized by dilation and destruction of larger bronchi **Mucus build up attracts bacteria/m..."

ClaireLewis: Created page with "==Background== Uncommon disease caused by chronic infection and inflammation Characterized by dilation and destruction of larger bronchi **Mucus build up attracts bacteria/m..."