Infectious Disease Compendium

Bronchiectasis

Diagnosis

Dilations/destruction of the airway. They become colonized with a wide variety of bacteria, mycobacteria, and molds. Patients are miserable with a chronic productive cough.

Epidemiologic Risks

Smoking and cystic fibrosis.

Microbiology

Anything can colonize and the microbiology can change as underlying disease progresses and the bugs evolve resistance. MAI and aspergillus are particular problems.

Empiric Therapy

Depends on what grows. Antibiotics are most beneficial for acute exacerbations. As with all chronic conditions, there are guidelines.

In non-CF bronchiectasis, the daily azithromycin results in a lower rate of infectious exacerbations compared to placebo. This could result in better quality of life and might influence survival, although 88% developed antibiotic resistance (PubMed).

Pearls

RA patients treated with biologics have increased rates of pneumonia (PubMed).

Rants