Bronchiectasis
Acquired bronchiectasis; Congenital bronchiectasis; Chronic lung disease - bronchiectasisBronchiectasis is a disease in which the large airways in the lungs are damaged. This causes the airways to become permanently wider.
Bronchiectasis can be present at birth or infancy or develop later in life.
Causes
Bronchiectasis is often caused by inflammation or infection of the airways that keeps coming back.
Sometimes it begins in childhood after having a severe lung infection or inhaling a foreign object. Breathing in food particles can also lead to this condition.
Inhaling a foreign object
If you swallow a foreign object, it can get stuck in the gastrointestinal (GI) tract from the esophagus (swallowing tube) to the colon (large intesti...
Read Article Now Book Mark ArticleOther causes of bronchiectasis can include:
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Cystic fibrosis, a disease that causes thick, sticky mucus to build up in the lungs
Cystic fibrosis
Cystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of th...
Read Article Now Book Mark Article - Autoimmune disorders, such as rheumatoid arthritis, Sjögren syndrome or inflammatory bowel disease
Sjögren syndrome
Sjögren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The...
Read Article Now Book Mark Article - Allergic lung diseases
- Leukemia and related cancers
- Immune deficiency syndromes
- Primary ciliary dyskinesia (another congenital disease)
- Infection with non-tuberculous mycobacteria
- As a complication of bronchiolitis obliterans
- Asthma or chronic obstructive lung disease (uncommon)
Symptoms
Symptoms develop over time. They may occur months or years after the event that causes the bronchiectasis.
Long-term (chronic) cough with large amounts of foul smelling sputum is the main symptom of bronchiectasis. Other symptoms may include:
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Breath odor
Breath odor
Breath odor is the scent of the air you breathe out of your mouth. Unpleasant breath odor is commonly called bad breath.
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Coughing up blood (less common in children)
Coughing up blood
Coughing up blood is the spitting up of blood or bloody mucus from the lungs and throat (respiratory tract). Hemoptysis is the medical term for cough...
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Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
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Paleness
Paleness
Paleness is an abnormal loss of color from normal skin or mucous membranes.
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Shortness of breath that gets worse with exercise
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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Weight loss
Weight loss
Unexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...
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Wheezing
Wheezing
Wheezing is a high-pitched whistling sound during breathing. It occurs when air moves through narrowed breathing tubes in the lungs.
Read Article Now Book Mark Article - Low grade fever and night sweats
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Clubbing of fingers (rare, depends on cause)
Clubbing
Clubbing is changes in the areas under and around the toenails and fingernails that occur with some disorders. The nails may also show changes....
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Exams and Tests
The health care provider will perform a physical exam. When listening to the chest with a stethoscope, the provider may hear small clicking, bubbling, wheezing, rattling, or other sounds, usually in the lower lungs.
Tests that may be done include:
- Aspergillosis precipitin test (to check for signs of an allergic reaction to fungus)
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Alpha-1 antitrypsin blood test
Alpha-1 antitrypsin blood test
Alpha-1 antitrypsin (AAT) is a laboratory test to measure the amount of AAT in your blood. The test is also done to check for abnormal forms of AAT....
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Chest CT
Chest CT
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Sputum culture
Sputum culture
Routine sputum culture is a laboratory test that looks for germs that cause infection. Sputum is the material that comes up from air passages when y...
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Complete blood count (CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark Article - Genetic testing, including sweat test for cystic fibrosis and tests for other diseases (like primary ciliary dyskinesia)
Sweat test
Sweat electrolytes is a test that measures the level of chloride in sweat. Sweat chloride test is the standard test used to diagnose cystic fibrosis...
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PPD skin test to check for a past tuberculosis infection
PPD skin test
The PPD skin test is a method used to diagnose silent (latent) tuberculosis (TB) infection. PPD stands for purified protein derivative.
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Serum immunoglobulin electrophoresis to measure proteins called immunoglobulins in the blood
Serum immunoglobulin electrophoresis
Serum immunoelectrophoresis is a lab test that measures proteins called immunoglobulins in the blood. Immunoglobulins are proteins that function as ...
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Lung function tests to measure breathing and how well the lungs are functioning
Lung function tests
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
Read Article Now Book Mark Article - Immune deficiency workup
Treatment
Treatment is aimed at:
- Controlling infections and sputum
- Relieving airway blockage
Airway blockage
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
Read Article Now Book Mark Article - Preventing the problem from becoming worse
- Treating the underlying cause (for example modulator therapy for people with cystic fibrosis)
Daily drainage to remove sputum is part of treatment. A respiratory therapist can show the person coughing exercises that will help.
Medicines are often prescribed. These include:
- Antibiotics to treat infections
- Bronchodilators to open up airways
- Expectorants to help loosen and cough up thick sputum
Surgery to remove (resect) the lung may be needed if medicine does not work and the disease is in a small area, or if the person has a lot of bleeding in the lungs. It is more commonly considered if there is no genetic or acquired predisposition to bronchiectasis (for example, more likely to consider if there is bronchiectasis in one segment of the lung only because of prior obstruction).
Resect
Lung surgery is surgery done to repair or remove lung tissue. There are many common lung surgeries, including:Biopsy of an unknown growth in or arou...
Read Article Now Book Mark ArticleIn severe cases, lung transplantation might be needed.
Outlook (Prognosis)
The outlook depends on the specific cause of the disease. With treatment, most people live without major disability and the disease progresses slowly.
Possible Complications
Complications of bronchiectasis may include:
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Cor pulmonale
Cor pulmonale
Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the pulmonary arteries of the lung an...
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- Low oxygen levels (in severe cases)
- Recurrent pneumonia
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
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When to Contact a Medical Professional
Contact your provider if:
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Chest pain or shortness of breath gets worse
Chest pain
Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.
Read Article Now Book Mark Article - There is a change in the color or amount of phlegm you cough up, or if it is bloody
- Other symptoms get worse or do not improve with treatment
Prevention
You can reduce your risk by promptly treating lung infections.
Childhood vaccines a yearly flu vaccine, and COVID-19 vaccines help reduce the chance of some infections. Avoiding upper respiratory infections, smoking, and pollution may also reduce your risk of getting this infection.
Vaccines
Vaccines are used to boost your immune system and prevent the risk of infection and the severity of infections, including those that cause serious, l...
Read Article Now Book Mark ArticleFlu vaccine
All content below is taken in its entirety from the CDC Inactivated Influenza Vaccine Information Statement (VIS) www. cdc. gov/vaccines/hcp/vis/vis-...
Read Article Now Book Mark ArticleCOVID-19 vaccines
COVID-19 vaccines are used to prepare the body's immune system to protect against COVID-19. Everyone ages 6 months and older should get a 2024-2025 C...
Read Article Now Book Mark ArticleReferences
Chang AB, Redding GJ. Bronchiectasis and chronic suppurative lung disease. In: Wilmott RW, Deterding R, Li A, et al, eds. Kendig's Disorders of the Respiratory Tract in Children. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 26.
O'Donnell AE. Bronchiectasis, atelectasis, cysts, and localized lung disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 84.
Solomon GM, Chan ED. Bronchiectasis. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 69.
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Lungs - illustration
The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
Lungs
illustration
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Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
-
Lungs - illustration
The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
Lungs
illustration
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
Review Date: 7/31/2022
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.