Bronchiectasis

Presentation: think of nonsmoker with COPD, hemoptysis

NOTE: MAC (some debate if it's a chicken or egg came first)

Unknown why it's uncommon in patients who are obese

CT Diagnosis: [ ] criteria? Airway > vessel. Should be 1.5x to make clear dx.

In addition to the radiographic findings, to have the clinical syndrome they should have symptoms attributable to it

Fundamentally, mucus is good and is antimicrobial properties secretions. However mucus plus bacteria equals sputum, which if persistent does indicate a problem.

More than two anabiotic prescriptions for respiratory infections within six months, or airflow obstruction in a non-smoker should both prompt evaluation for bronchiectasis with CT scan

##Treatment

Mechanical: Acapella valve, manual percussive therapy, aerobic exercise Pharm: ALbuterol, hypertonic saline. Mucolytics (e.g. NAc) maybe only in CF, not in others.

If MAC excluded (to avoid monotherapy), can use chronic azithromycin.

Exacerbations: add antibiotics guided by sputum culture.