Bronchiectasis: Comorbid, Coexisting, and Differential Diagnosis
- DOI:
- 10.1093/med/9780199918065.003.0008
Bronchiectasis is one of the most debilitating chronic respiratory diseases, which affects all ages, with significant morbidity and mortality. It is recognized clinically by chronic persistent daily cough, productive of mucopurulent sputum. The defining characteristic is the permanent abnormal dilatation and destruction of bronchial walls, which involve both the major bronchi and bronchioles. It is a major contributor to progressive lung function decline and functional disability, especially in patients with respiratory comorbidities. Bronchial hygiene, to clear airway secretions, is the basis of management. Bronchodilators and fixed-dose combination therapy with an inhaled corticosteroid and a long-acting β-agonist provide clinical benefit, but do not reduce the risks for acute exacerbations. The airways of patients with bronchiectasis are often colonized with pathologic bacteria, and acute exacerbations require antibiotic therapy. Allergic bronchopulmonary aspergillosis often requires daily oral corticosteroids for management.
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