Suppurative Lung

Suppurative Lung

Disease Bronchiectasis

Pathology:                    Abnormaland permanently dilated airways with increased mucus production, decreasedmucus clearance and recurrent infections


Aetiology:                    Postinfection, immune overactivity (ABPA) and immune deficiency(hypogammaglobulinaemia), cystic fibrosis, Kartagener’s Syndrome (situsinversus and ciliary dysfunction), bronchial obstruction, rheumatoid arthritis,idiopathic


Symptoms:                   Persistent,productive cough with large volumes of purulent sputum, haemoptysis, dyspnoea,recurrent infections, weight loss


Signs:                              Fingerclubbing, coarse inspiratory crackles over the affected area, halitosis, wheeze


Investigations:          Chest X-Ray: May be normal

High Resolution CT: Bronchial damage

Microbiology: Sputum cultures

Other: Lung function tests and Cystic Fibrosis testsif <40 years/suspicion of CF


Treatment:                  Physiotherapyfor sputum clearance

Antibioticsto treat infections

Treatco-existing lung disease


Complications:          Recurrentinfections causing progressive lung damage and respiratory failure


Prognosis:                    Generallydeteriorate over time/with exacerbations. Rate of decline linked to organismsin sputum

















                                                                                      Thickened, Dilated Bronchi

(Signet Ring Sign)


Figure 2.11 CTBronchiectasis


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