The diagnosis of bronchiectasis is based on clinical presentation with consistent radiographic findings, such as parallel “tram tracks,” a “signet-ring sign” (a cross-sectional area of the airway with a diameter at least 1.5 times that of the adjacent vessel), lack of bronchial tapering, bronchial wall thickening, or cysts emanating from the bronchial wall.
Treatment: Bronchiectasis Treatment of infectious bronchiectasis is directed at the control of active infection and at improvements in secretion clearance and bronchial hygiene. - Acute exacerbations should be treated with a 7- to 10-day course of antibiotics targeting the causative or presumptive pathogen; H. influenzae and P. aeruginosa are isolated commonly.
- Hydration and mucolytic administration, aerosolization of bronchodilators and hyperosmolar agents (e.g., hypertonic saline), and chest physiotherapy can be used to enhance secretion clearance.
- For pts with ≥3 recurrences per year, suppressive antibiotic treatment to minimize the microbial load and reduce the frequency of exacerbations has been proposed.
- In select cases, surgery (including lung transplantation) should be considered.
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