Non‐cystic fibrosis bronchiectasis

Abstract

Non-cystic fibrosis (CF) bronchiectasis is said to be a declining problem in developed countries, although its prevalence in indigenous communities in Australia and New Zealand is among the highest reported in the world. Early childhood pneumonia and underlying conditions such as immunodeficiency and primary ciliary dyskinesia need to be considered in the aetiology. A high-resolution computerised tomography scan is the key investigation in children with a chronic wet cough in whom bronchiectasis is suspected. Regardless of the cause, the treatment of bronchiectasis is centred upon facilitating the clearance of airway secretions and the treatment of pulmonary exacerbations. This review aims to provide general paediatricians with an update on the presenting features, investigation and management of non-cystic fibrosis bronchiectasis.

An underestimated cause of chronic cough: The protracted bacterial bronchitis

“…A vicious cycle of infection-inflammation ensues and probably pushes patients along the clinical spectrum of the BBP, to chronic suppurative lung disease and finally bronchiectasis. [ 20 35 ]…”

Bronchiectasis following treatment for high‐risk neuroblastoma: A case series

“…Bronchiectasis is pathologically distinct from other lung conditions such as pulmonary fibrosis. The pathological hallmark of bronchiectasis is abnormal bronchial dilatation, copious purulent secretions, and evidence of inflammation within the surrounding lung tissue …”

Bronchiectasis: why the diagnosis shouldn't be missed in primary care

“…7 Furthermore, in some children with bronchiectasis, resolution or considerable improvement of the changes seen on HRCT scanning of the chest have been noted, underlining the importance of early diagnosis and treatment of the condition. 5,7 It is for these reasons that early diagnosis and institution of appropriate care are essential.…”

“…[1][2][3][4] The diagnosis should also be considered in children with "asthma" that responds poorly to treatment, and similarly in adults with "chronic obstructive pulmonary disease (COPD)". 2,4,5,9 The plain chest X-ray -which is recommended for all patients -is not sufficiently sensitive for adequate diagnosis of the condition, and the use of bronchography has been replaced by HRCT scanning of the chest, which is currently considered the gold standard for bronchiectasis diagnosis. 1,2 It is the more widespread use of HRCT scanning that has largely contributed to the recognition of the importance of bronchiectasis.…”

“…However, since the advent of high resolution CT (HRCT) scanning of the chest, the diagnosis of bronchiectasis is being made with increasing frequency throughout the world and the condition has become recognised as an important and common cause of respiratory disease. [2][3][4][5] Bronchiectasis is important to recognise since it may cause severe and recurrent pulmonary infections, with associated permanent and progressive loss of lung function leading to significant morbidity and even premature mortality. 1 For example, a recent mortality study conducted in England and Wales reported the number of deaths from bronchiectasis to be increasing by 3% per annum in the older age groups, and this despite likely underreporting -thus necessitating increased clinical provision for these patients to reverse this trend.…”