Bronchiectasis: Signs and Diagnosis

Bronchiectasis refers to irreversible (irreversible) pathologic (pathological) dilatations (enlargements) of the bronchi (synonyms: Bronchiectasis; bronchial dilatation; ICD-10-GM J47: bronchiectasis) that are preceded by damage to the bronchial walls from repeated inflammation (inflammation) and disruption of the drainage of bronchial secretions. “Ectasis” comes from the Greek and translates as “expansion.” The expansions can be saccular, spindle-shaped, or cylindrical (most common).

The disease primarily affects the basal (lower) lung segments. A lung segment or an entire lobe of the lung may be affected. Likewise, bronchiectasis can occur in both lobes of the lung.

Bronchiectasis can be congenital (congenital) or acquired (more common form) (see “Causes”).

Common causes of bronchiectasis include repeated lower respiratory tract infections in childhood and cystic fibrosis (synonym: cystic fibrosis (CF)) (in Europe). In developing countries, bronchiectasis occurs mainly postinfectiously (after an infection such as pertussis, measles, influenza). In industrialized nations, postinfectious disease rates are declining due to the use of antibiotics and vaccination programs.

Peak incidence: The disease occurs predominantly in middle age.

The prevalence (disease incidence) is 3.7 cases per 100,000 population in New Zealand and 52 cases per 100,000 population in the United States.

Approximately 30-50% of patients with chronic obstructive pulmonary disease (COPD) have bronchiectasis in the advanced stages.

Course and prognosis: Exacerbations (periods of marked worsening of the disease) are typical of the course of this chronic disease. Each patient undergoes about 1.5 episodes of disease per year. During these, the patient suffers from four or more of the symptoms characteristic of bronchiectasis (see under “Symptoms – Complaints”). More frequent episodes, chronic colonization with the bacterium Pseudomonas aeruginosa, and evidence of systemic inflammation (inflammation affecting the whole body) indicate progression of the disease.The mainstay of therapy is the use of antibiotics and physiotherapy (respiratory exercises).

The prognosis depends on how well infections can be avoided. In the best case, the life expectancy of the affected person is hardly limited.