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Bronchiectasis

*From the Georgetown University Medical Center, Washington, DC.

Correspondence to: Anne E. O'Donnell, MD, FCCP, Division of Pulmonary, Critical Care, and Sleep Medicine, Georgetown University Hospital, 3800 Reservoir Rd NW, 4 North Main Hospital, Washington DC 20007; e-mail: odonnela{at}georgetown.edu

Abstract

Bronchiectasis, which was once thought to be an orphan disease, is now being recognized with increasing frequency around the world. Patients with bronchiectasis have chronic cough and sputum production, and bacterial infections develop in them that result in the loss of lung function. Bronchiectasis occurs in patients across the spectrum of age and gender, but the highest prevalence is in older women. The diagnosis of bronchiectasis is made by high-resolution CT scans. Bronchiectasis, which can be focal or diffuse, may occur without antecedent disease but is often a complication of previous lung infection or injury or is due to underlying systemic illnesses. Patients with bronchiectasis may have predisposing congenital disease, immune disorders, or inflammatory disease. The treatment of bronchiectasis is multimodality, and includes therapy with antibiotics, antiinflammatory agents, and airway clearance. Resectional surgery and lung transplantation are rarely required. The prognosis for patients with bronchiectasis is variable given the heterogeneous nature of the disease. A tailored, patient-focused approach is needed to optimally evaluate and treat individuals with bronchiectasis.

Key Words: bronchiectasis • microbiology • nontuberculous mycobacterium • pulmonary disease

Abbreviations: AAT, ₁-antitrypsin • ABPA, allergic bronchopulmonary aspergillosis • CF, cystic fibrosis • HRCT, high-resolution CT • NTM, nontuberculous mycobacterium • PCD, primary ciliary dyskinesia