Bronchiectasis describes a permanent dilatation of the airways secondary to chronic infection or inflammation. After assessing for treatable causes (e.g. immune deficiency) management is as follows:

• physical training (e.g. inspiratory muscle training) - has a good evidence base for patients with non-cystic fibrosis bronchiectasis
• postural drainage
• antibiotics for exacerbations + long-term rotating antibiotics in severe cases
• bronchodilators in selected cases
• immunisations
• surgery in selected cases (e.g. Localised disease)

Most common organisms isolated from patients with bronchiectasis:

• Haemophilus influenzae (most common)
• Pseudomonas aeruginosa
• Klebsiella spp.
• Streptococcus pneumoniae

3D illustration showing the typical changes found in bronchiectasis

Imaging

Chest x-ray showing tramlines, most prominent in the left lower zone

CT chest showing widespread tram-track and signet ring signs