Clinical Case Database / Category: Patient Management

Management of recurrent infective exacerbations of bronchiectasis

Publication details

Bethannie McIntyre, Nabil Jarad
Foundation Years Journal, volume 9, issue 4, p.6 (123Doc Education, London, April 2015)

Abstract

The rate of non cystic fibrosis (CF) bronchiectasis is increased due to increase
diagnosis and to aging. This is a chronic respiratory condition associated
with abnormal irreversible bronchial airway dilatation. The condition is
characterised by recurrent airway infections, persistent symptoms of cough
and sputum production and a subsequent decline in respiratory function.
It often results in patients requiring multiple hospital admissions. As a
foundation junior doctor you may be expected to manage patients with
bronchiectasis. This article is a case-based discussion on a patient presenting
repeatedly with infective exacerbations of bronchiectasis.
It covers recognition of the unwell patient with an infective exacerbation
and details the investigations and management that should be instigated.
Bronchiectasis may be the result of a previous respiratory infection or
an underlying systemic disease however in many cases it is idiopathic.
Management of bronchiectasis should be targeted at both the acute
presentation of an infective exacerbation as well as improving chronic
respiratory symptoms and preserving respiratory function. Treatment should
be tailored to the patient and their symptoms and is multimodal including
airway clearance techniques, mucolytics and antibiotics. There is evidence
that long term oral and nebulised antibiotic use is beneficial in sub groups of
patients with bronchiectasis.

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Authors

Bethannie McIntyre

Foundation Year 2 Doctor
University Hospitals Bristol NHS Foundation Trust
Dolphin House, Level 4, Bristol Royal Infirmary, Bristol, BS2 8HW
bethannie.mcintyre@uhbristol.nhs.uk

Nabil Jarad (Corresponding author)

Consultant Respiratory Physician
University Hospitals Bristol NHS Foundation Trust
Dolphin House, Level 4, Bristol Royal Infirmary, Bristol, BS2 8HW
nabil.jarad@uhbristol.nhs.uk

References

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