Permanent abnormal bronchial dilatation with chronic sputum production and recurrent infective exacerbations.
Causes
- • Post-infective (TB, pertussis, measles)
- • Cystic fibrosis
- • Immunodeficiency
- • ABPA
- • Primary ciliary dyskinesia
- • Rheumatoid arthritis
Investigations
- • High-resolution CT chest (signet-ring sign)
- • Sputum culture including mycobacteria and Pseudomonas
- • Immunoglobulins, CF sweat test/genetics, aspergillus IgE
- • Spirometry
Management
- • Daily airway clearance and physiotherapy
- • Prompt 14-day antibiotics for exacerbations guided by prior cultures
- • Eradication protocol for new Pseudomonas
- • Azithromycin 250 mg 3×/week if ≥3 exacerbations/year
- • Pulmonary rehabilitation and vaccination
Clinical pearls
- • Never treat as simple COPD — the microbiology and antibiotic duration differ
- • Massive haemoptysis warrants bronchial artery embolisation
Related in WardRound
Educational — verify locally.
