Bronchiectasis is a disease of the airways of the lungs caused by repeated and chronic infections. The infections damage the walls of the larger airways causing them to dilate and become “flabby”. These airways are then sources of chronic infection and mucous production, and even the coughing up of blood. In children the most common cause is usually cystic fibrosis, but in adults a recent study produced some surprising results.
The study included 1826 patients that were enrolled over a 6 year period. 63% of these patients were found to have an infection with a non-tuberculous mycobacterium (NTM). These bacteria are related to, and in the same family as, TB. Most of the patients were women (73%) and were diagnosed between the ages of 50 and 75. The symptoms of this problem included chronic cough, fatigue and shortness of breath. Most of the patients were found to have reduced airflow on pulmonary function testing. I should note that almost all patients also grew an organism called pseudomonas from their sputum cultures. This organism is hard to treat and eradicate, and is frequently present in the airways of patients with bronchiectasis.
Making the diagnosis of bronchiectasis is usually made by CT scanning the chest with a technique called high resolution. Finding NTM often requires obtaining specimens of bronchial mucous with fiberoptic bronchoscopy. The treatment of NTM usually requires the use of several drugs that may need to be given over a long period of time.
