Abstract
Introduction: Bronchiectasis can be defined as the chronic dilatation of one or more bronchi and is an important substrate for respiratory tract infections, presenting relapses and colonization with resistant bacterial strains. Underdiagnosis and variation in aetiology make the impact of bronchiectasis hard to determine.
Aim: The diagnosis of bronchiectasis in patients with indirect chest radiographic (CXR) signs and a compatible clinical picture, as well as the determination of the possible cause for the proper treatment of patients.
Materials and methods: 58 patients were hospitalized for one year in our institution, with a history of recurrent infections and chronic cough. The CXR revealed indirect signs of bronchiectasis. The diagnosis was confirmed with a spiral chest CT scan of 7mm and 1mm transverse sections.
Results: Underlying diseases were identified in 50 patients: old TBC in 20 (34.4%), COPD in 24 (41.4%), GERD in 4 (6.9%) and pulmonary fibrosis in 2 patients (3.5%). 31 patients had positive sputum cultures (53.5%), Gram-negative bacteria were isolated from 30 patients (68%), 13 patients (43.3%) of whom were isolated with Pseudomonas aeruginosa. Aetiological therapeutic treatment was followed and on negative cultures empiric treatment was administered based on potential microbial agents developed in patients with bronchiectasis. Antibiotic therapy has been extended to 14 days and patients underwent intensive physiotherapy for partial drainage. Patients with GERD received the appropriate medication and instructions on changing their dietary habits.
Conclusions: Diagnosis of bronchiectasis and determination of its aetiology alters the short as well as the long-term therapeutic treatment of patients.
- Copyright ©ERS 2015