Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences
Bronchiectasis
Other Resources UpToDate PubMed

Bronchiectasis

Contributors: Casey Silver MD, Mary Anne Morgan MD, Michael W. Winter MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Bronchiectasis is a disorder of the airways leading to airway dilatation and destruction, chronic sputum production, and a tendency toward recurrent infection. The condition can be seen in isolation or as a consequence of other pulmonary and systemic conditions such as asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, alpha-1 antitrypsin deficiency (ATTD), primary ciliary dyskinesia, as well as various autoimmune, rheumatologic, and immunodeficiency conditions.

Bronchiectasis is the consequence of multiple contributing factors culminating in a viscous cycle of respiratory infection, inflammation, and damage. An initial respiratory insult or preexisting condition results in impaired secretion clearance and subsequent infection with inflammation, leading to remodeling and dilation of the airways, further impairing airway secretion clearance and setting the stage for recurrent infection, inflammation, and recurrent damage and remodeling.

Patients typically present with chronic cough, often but not always with sputum production, with a course characterized by intermittent exacerbations. It can be difficult to distinguish from pneumonia in many circumstances. Management involves treating the underlying etiology and improving airway clearance to break the cycle of recurrent infections and progressive airway destruction.

When bronchiectasis is caused by an underlying chronic medical condition (eg, cystic fibrosis, ATTD), daily maintenance is critical to minimizing morbidity from bronchiectasis.

Codes

ICD10CM:
J47.9 – Bronchiectasis, uncomplicated

SNOMEDCT:
12295008 – Bronchiectasis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Cystic fibrosis
  • Chronic bronchitis
  • Chronic obstructive pulmonary disease (COPD)
  • Bronchiolitis
  • Mycobacterial lung disease (eg, Tuberculosis)
  • Endobronchial obstruction (Foreign body aspiration, tumor)
  • Tracheobronchomalacia and tracheobronchomegaly (see Tracheomalacia)
  • Primary ciliary dyskinesia
  • Hypogammaglobulinemia (eg, Congenital agammaglobulinemia)
  • Young syndrome
  • Alpha-1 antitrypsin deficiency
  • Allergic bronchopulmonary aspergillosis
  • Asthma

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:04/23/2019
Last Updated:03/21/2023
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Bronchiectasis
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A medical illustration showing key findings of Bronchiectasis : Chest pain, Productive cough, Dyspnea, Wheezing, Crackles
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