Bronchiectasis (Acquired, Congenital) (cont.)

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What are the signs and symptoms of bronchiectasis?

The signs and symptoms of bronchiectasis develop and change over time. The first common symptoms include a recurrent cough and sputum production; usually the sputum/mucous is clear but eventually may become bloody if injuries to the bronchial wall occur. In addition, mucous may change to a green or yellow color when infection is present. As the disease progresses, chronic coughing with mucous production increases and the person usually becomes more fatigued and short of breath as lung function decreases. Some people may develop wheezing; some may lose weight due to the increased effort needed to breathe. Occasionally, symptoms of a primary disease like pneumonia may mask some of the symptoms of bronchiectasis so it may be more difficult to diagnose bronchiectasis if an underlying disease is present.

When should I contact my doctor for bronchiectasis?

You should contact your doctor for medical care if you have a chronic cough (lasting about three weeks or more), a new onset of shortness of breath and/or any coughing up blood (hemoptysis). Individuals who have repeated bouts of pneumonia and increased sputum production should also seek medical care.

How is the diagnosis of bronchiectasis made?

The diagnosis of bronchiectasis usually involves a history and physical exam, with a history being a chronic daily cough and sputum production. Sputum analysis, chest X-ray and high-resolution CT of the chest (lungs) are tests usually ordered. In most cases, the definitive diagnosis is made with the CT of the chest although occasionally a chest X-ray is sufficient. These exams usually show the changes in the bronchioles that are consistent with bronchiectasis.

For some patients, other tests may be ordered to determine if underlined diseases are contributing to bronchiectasis. Such tests include alpha-1 antitrypsin levels, autoimmune screening tests, and measures of vitamin D deficiency as this is commonly found in bronchiectasis and correlates with disease severity. Patients may need to be tested for cystic fibrosis. Chronic infections like fungal infections (Aspergillus) may need to be ruled out.

Pulmonary function tests also may be ordered to determine the patient's baseline lung function to help determine the extent of lung tissue compromise.

Medically Reviewed by a Doctor on 6/1/2015

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