bronchiectasie

Bronchiectasie, often referred to as bronchiectasis, is a chronic lung condition defined by irreversible dilation and distortion of the bronchi. The abnormal airways impair mucociliary clearance, enabling mucus accumulation and recurrent infections that sustain inflammation and further airway damage. The disorder can involve one or several lobes and may result from various causes or occur without a clear precipitant.

Causes and risk factors include postinfectious injury (notably in childhood), primary immunodeficiency, genetic conditions such as primary ciliary dyskinesia or cystic fibrosis, allergic bronchopulmonary aspergillosis, autoimmune diseases, and smoking-related lung disease. In many adults, no single cause is identified.

Symptoms commonly include a chronic productive cough with copious sputum, frequent respiratory infections, dyspnea, wheeze, chest pain, and occasionally hemoptysis. Physical findings vary; crackles or rhonchi may be heard. The diagnosis rests on imaging, especially high-resolution CT, which shows dilated bronchi and airway wall thickening. CT features can include the signet ring sign and tram-track markings. Spirometry often shows an obstructive pattern, while tests for underlying causes guide further workup.

Management focuses on improving airway clearance, treating infections, and addressing underlying etiologies. Chest physiotherapy, mucolytics, bronchodilators, and inhaled corticosteroids are used selectively. Antibiotics are the main treatment for exacerbations, with long-term antimicrobial therapy considered in selected patients. Vaccinations, CF-directed therapies when applicable, and, in localized disease, surgery or transplantation for advanced cases may be considered.

Prognosis varies with severity and responsiveness to therapy. With proper management, many people stabilize and maintain quality of life, though lung function may progressively decline in some.