Professional Documents
Culture Documents
Approach To Bronchiectasis: Kyle Perrin
Approach To Bronchiectasis: Kyle Perrin
Approach To Bronchiectasis: Kyle Perrin
Kyle Perrin
Overview
• Risk factors
• Diagnosis
– History
– Examination
– Investigations
• Approach to management
What is bronchiectasis?
• Foreign body
• Previous
– Frequent childhood infections?
– Foreign body?
– Other infections? (sinus, skin etc)
• Current
– Recurrent chest infections
– Chronic production of purulent sputum
– Haemoptysis
– Wheeze
– Breathlessness
Examination
• Occasional wheeze
Investigations
• Spirometry
– Obstructive, but may be normal
• Sputum test
• Duration?
• Frequency?
Inhaled drug therapy
• Mucolytics
– Pulmozyme (not effective)
– Mannitol
• Bronchodilators?
• Inhaled corticosteroids?
Long term antibiotics
• Nebulised tobramycin
• Oral azithromycin
Exacerbations
Need for admission
• If no sputum available
– Augmentin is a reasonable first choice
– Send a sputum and modify if necessary
Other treatments
• Vaccinations
• Pulmonary rehab
• Surgery
• Lung transplant
A case
Hannah age 16
• Seretide 2 puffs bd
• Lotatadine 10mg od
• Montelucast 10mg od
• Flixonase 2 puffs bd
• Theophyline 250mg od
Social history