Bronchiectasis: A Neglected Disease

1. Bronchiectasis is a common disease. Among 9754 cases admitted to a large naval hospital 59 cases were found, an incidence of 0.6 per cent. This incidence is comparable to that of pulmonary tuberculosis as determined by mass surveys.

2. In only six patients of this series had a diagnosis of bronchiectasis been made prior to their admission to the naval hospital from which final disposition was made.

3. Most cases of bronchiectasis follow streptococcal respiratory infection of one type or another, the most common being bronchopneumonia. Sinusitis was not found commonly to precede or accompany bronchiectasis.

4. The expectoration of large quantities of foul sputum and clubbing of the fingers were found to be distinctly uncommon in this series. Foul sputum was found in but two cases and clubbing of the fingers in but one.

5. Persistent cough and expectoration following a respiratory illness occurred in every case in this series. The persistence of this combination of symptoms following an acute respiratory illness should always make the physician think of bronchiectasis.

6. The commonest radiographic findings were thickening and fuzziness of the lung markings at the bases of the lungs. When these findings occur together with persistent cough and expectoration, bronchiectasis is found on making bronchograms, in a high percentage of cases.

7. Bronchograms made with iodized oil are the only sure means of diagnosing bronchiectasis. They are simply and easily made by means of the supraglottic method of instilling iodized oil into the tracheobronchial tree.

8. Lobectomy is as surely established as the treatment for certain types of bronchiectasis as is appendectomy for the treatment of acute appendicitis, but its usefulness has been sharply limited by the lateness with which most cases of bronchiectasis are diagnosed.