BRONCHIECTASIS jj

8/4/2019 BRONCHIECTASIS jj

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BRONCHIECTASISCOMPLICATIONS & DIFFERENTIAL

DIAGNOSIS

JJ.JENSON


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COMPLICATIONS Hemoptysis

Lung abscess

Pyothorax

Cor pulmonale

Recurrent pnemonia

Cavity formation


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HEMOPTYSIS

MECHANISM:

Vascular enlargement of dilated bronchialvessels resulting in the erosion of the adjacentbronchial arterioles &pulmonary capillariesresults in massive hemoptysis

Management:Blood transfusion,oxygen therapy


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LUNG ABSCESS

Mechanism:

Chronic bronchial inflammation secondary toinappropriate clearance of various microorganisms leading to infection which results inLung abscess

Organisms:Anaerobes,Staphylococci,Psuedomonas

Clinical ftrs:fever,cough with purulent sputum


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Contd..

Hemoptysis may be associated

Management:Application of antibiotics,posturaldrainage,


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PYOTHORAX

Mechanism:

Pus getting collected in the plueral cavity due torepeated infections leads to pyothorax

Symptoms:cough,fever,chest pain,shortness ofbreathing

Diagnosis:Pus culture&tests for antibioticsensitvity

Treatment:Thoracocentesis


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CORPULMONALE

Enlargement of right ventricle with or withoutfailure secondary to disease of lung&pulmonarycirculation

Clinical ftrs:Palpitation,dyspnea,edema

Treatment:Diuretics,vasodilators,control of

infection


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RECURRENT PNEMONIA

Exudative solidification of lung tissue

Causes:Foreign bodies

Management:Sputum examination,bloodculture,serology(mycoplasma,chlamydia)

Pnuemococcal:PenicillinG 50,000 units/kg/day

can be given intravenously in divided doses for aweek to ten days


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CAVITY FORMATION

Results due to the tuberculous involvement ofbronchial wall

Mechanism:it occurs in post-primarytuberculous patients due to cicatrialbronchostenosis which leads to destruction of

lung parenchyma Apical&posterior segments of the upper lobe is

involved


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RARE COMPLICATIONS

Septicemia

Amyloidosis

Respiratory failure

Metastatic abscess to the brain


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DIFFERENTIAL DIAGNOSIS based onSYMPTOMS

COUGH WITH SPUTUM

CRACKLES


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DD for COUGH WITH SPUTUM

Based on 1)Amount of sputum production

2)Colour of the sputum


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Amount of Sputum

Sudden production of large amount of purulentsputum on a single occasion-rupture of lung

abscess

Large volume of watery sputum with a pinkishtinge-acute pulmonary edema


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COLOUR&TYPE OF SPUTUM

Green,purulent sputum Pnuemonia,Cysticfibrosis

Yellow,purulent sputum-Acutebronchopulmonary infection

Mucoid sputum-Chronic bronchitis

Pink,frothy,serous sputum-Acute pulmonaryedema

Rusty red sputum-Pnuemococcal pnemonia


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CRACKLES

Crackles are defined as non-musical,interruptedadded sounds of short duration,explosive in

nature

TYPES-1)Fine crackles

2)Coarse crackles

Fine crackles

sign of parenchymal infiltration Apex of lung-pulmonary tuberculosis

Diffuse fine crackles-Pnuemonia


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COARSE CRACKLES

Coarse leathery crackles heard in base of lung-Bronchiectasis

If heard diffusely all over lung-Cysic fibrosis

Bronchitis

Moist bubbling crackles-pulmonary edema


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INSPIRATORY CRACKLES

Early inspiratory crackles-Bronchiolitis

Mid inspiratory crackles-Bronchiectasis

Late inspiratory crackles-pulmonary edema

EXPIRATORY CRACKLES-chronic bronchitis


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THANK

U

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BRONCHIECTASIS jj