What are the main causes of bronchiectasis

UnderBronchiectasisone understands irreversible (irreversible) pathological (pathological) Dilatations (Extensions) the bronchi (Synonyms: bronchiectasis; bronchial dilation; ICD-10-GM J47: bronchiectasis)which are preceded by damage to the bronchial walls due to repeated inflammation and disruption of the outflow of bronchial secretions. "ektasis" comes from the Greek and means "expansion". The expansions can be sack-shaped, spindle-shaped, or cylindrical (most often).

The disease mainly affects the basal (lower) sections of the lungs. A segment of the lung or an entire lobe of the lung can be affected. The bronchiectasis can also occur in both lungs.

Bronchiectasis can be congenital (congenital) or acquired (more common form) (see "Causes").

Common causes of bronchiectasis are repeated infections of the lower respiratory tract in childhood and cystic fibrosis (synonym: cystic fibrosis (CF)) (in Europe) [1]. In developing countries, bronchiectasis occurs primarily post-infectious (after an infection such as whooping cough, measles, influenza). In the industrialized nations, the post-infectious disease rate is falling due to the use of antibiotics and vaccination programs.

Frequency peak: The disease occurs mainly in middle age.

The Prevalence (Disease frequency) is 3.7 diseases per 100,000 people in New Zealand and 52 diseases per 100,000 people in the USA [2].

Approximately 30-50% of patients with chronic obstructive pulmonary disease (COPD) show bronchiectasis in the advanced stage [3].

Course and prognosis: Typical for the course of this chronic disease are exacerbations (phases in which the disease has clearly deteriorated). Each patient goes through around 1.5 flare-ups per year. The patient suffers from four or more of the symptoms characteristic of bronchiectasis (see under "Symptoms - Complaints"). More frequent relapses of the disease, chronic colonization with the bacterium Pseudomonas aeruginosa and evidence of systemic inflammation (inflammation that affects the whole body) suggest that the disease is progressing.
The main focus of therapy is the use of antibiotics and physiotherapy (breathing exercises).

The prognosis depends on how well it is possible to avoid infections. In the best case, the life expectancy of the person affected is hardly restricted.

literature

  1. Bilton D: Update on non-cystic fibrosis bronchiectasis. Curr Opin Pulm Med 2008; 14: 595-9
  2. Twiss J, Metcalfe R, Edwards E et al .: New Zealand national incidence of bronchiectasis "too high" for a developed country. Arch Dis Child 2005; 90: 737-40
  3. Patel IS, Vlahos I, Wilkinson TM et al .: Bronchiectasis, exacerbation indices, and inflammation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2004; 15; 170: 400-7

     
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