Bronchiectasis in adults: a review

Bronchiectasis is characterized by permanent, abnormal dilation of the bronchi with chronic inflammation and infection. Bronchiectasis is either caused by or associated with several systemic disorders, and in a significant number of cases, the underlying etiology remains unidentified and is subsequently referred to as idiopathic. The clinical course is characterized by chronic cough with purulent sputum associated with acute exacerbations. Patients may develop progressive decline in pulmonary function due to ongoing infection, inflammation, and destruction of bronchi if a delay in diagnosis and therapy occurs. With high-resolution computed tomography, the confirmatory diagnosis of bronchiectasis can be made promptly and diagnostic work-up for etiology initiated. Identifying a specific etiology, when present, is critical for implementing appropriate treatment of the underlying cause. Whether a specific etiology can be identified or not, all cases of bronchiectasis require management that addresses infection, inflammation, and bronchial toilet.