Respiratory System

BRONCHIECTASIS

destruction of small sized and medium sized bronchi
destruction of elastic and muscular elements

SIGNS AND SYMPTOMS

Chronic cough
Heamoptysis
Foul smelling sputum
Recurrent pulmonary infectoins( Psuedomonas)
sinusitis
immune deficiencies

wheezes /crackles
Secondary Polycythemia

Radiograph

Early:-Normal

Late stage:- 1-2 cm cysts, crowding of bronchi, tram tracking of bronchi

Best non-invasive way to diagnose :-HRCT

Treatment:-

• Control of Broncial secretions:-

* Bronchodilators
*Chest physical therapy
*Postural Drainage

• When sputum secretion increases or they have mild symptoms then(as Rotating Antibiotics ie diferent antibiotic each time to diminish resistance)

*Antibiotics
Amoxicillin, trimethoprim+sulphamethoxazole
Augmentin(Mox+clavulanic acid)

• In severe sypmtoms or Pneumonia

Give gram negative coverage
Ceftazidime, Quinolones, Aminoglycosides

Surgical Therapy
:considered with localized bronchiectasis with adequate pulmonary functions
:with massive hemoptysis

Vaccination
influenza annualy
Pneumococcus every 5 years

Complications
Massive heamoptysis
amyloidosis
cor pulmonale
visceral abscesses