***Overview:

Bronchiectasis is a permanent abnormal widening (dilation) in one or more of the airways (bronchi). Extra mucus tends to form and pool in the parts of the airways that are widened. Widened airways with extra mucus are prone to infection.

***Cause: > 50% case no cause can be found. Some common causes:

- Cystic fibrosis (CF) ( ~50% cases in US).
- Severe lung infections such as tuberculosis (TB), whooping cough, pneumonia or measles.
- Abnormal lung defenses.
- Obstruction of the airways by a foreign body or tumor.

***Symptoms:

* Chronic cough with large amounts of foul-smelling sputum (The main symptom )
* Bluish skin color
* Breath odor
* Clubbing of fingers
* Coughing up blood
* Cough that gets worse when lying on one side
* Fatigue
* Paleness
* Shortness of breath that gets worse with exercise
* Weight loss
* Wheezing

*** Diagnosis:

* Aspergillosis precipitin test (to check for signs of the aspergillosis fungus)
* Chest x-ray
* Chest CT ( HRCT)
* Sputum culture
* Complete blood count (CBC)
* PPD skin test to check for a prior tuberculosis infection
* Serum immunoglobulin electrophoresis
* Sweat test or other cystic fibrosis testing

*** Treatment:

- Medication: antibiotics, steroid inhaler, bronchodilator inhaler, Immunisation
- Physiotherapy and other ’exercise’ therapies, no smoking.
- Surgery to resect the lung may be needed if medicine does not work or if the patient has massive bleeding.

*** Complications:

* Cor pulmonale
* Coughing up blood
* Low oxygen levels (in severe cases)
* Recurrent pneumonia

*Cystic fibrosis (also known as CF, mucovoidosis, or mucoviscidosis) is an inherited autosomal recessive genetic disorder of the secretory glands, including mucus and sweat glands.
Lung disease results from clogging the airways due to mucosa build-up and resulting inflammation.
- Inflammation and infection cause injury and structural changes to the lungs, leading to a variety of symptoms.
- In the early stages, incessant coughing, copious phlegm production, and decreased ability to exercise are common. Many of these symptoms occur when bacteria that normally inhabit the thick mucus grow out of control and cause pneumonia.
- In later stages of CF, changes in the architecture of the lung further exacerbate chronic difficulties in breathing. Other symptoms include coughing up blood (hemoptysis), changes in the major airways in the lungs (bronchiectasis), high blood pressure in the lung (pulmonary hypertension), heart failure, difficulties getting enough oxygen to the body (hypoxia), and respiratory failure requiring support with breathing masks such as bilevel positive airway pressure machines or ventilators.
* The most commonly used form of testing is the sweat test. Sweat-testing involves application of a medication that stimulates sweating (pilocarpine) to one electrode of an apparatus and running electric current to a separate electrode on the skin. This process, called iontophoresis, causes sweating; the sweat is then collected on filter paper or in a capillary tube and analyzed for abnormal amounts of sodium and chloride. People with CF have increased amounts of sodium and chloride in their sweat.

- Result:
Chloride Concentration Result
< 40 mmol/L....................Normal
40-60 mmol/L..................Borderline or indeterminate
> 60 mmol/L....................Abnormal

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