Mb. Nicotra et al., CLINICAL, PATHOPHYSIOLOGIC, AND MICROBIOLOGIC CHARACTERIZATION OF BRONCHIECTASIS IN AN AGING COHORT, Chest, 108(4), 1995, pp. 955-961
Study objective: Awareness of bronchiectasis on the part of clinicians
has been low in recent years, although it was previously well recogni
zed, We believe that bronchiectasis is underdiagnosed, and that curren
t literature is skewed toward the esoteric etiologies of bronchiectasi
s. Design: We reviewed the clinical, radiologic, microbiologic, and ph
ysiologic findings in 123 well-studied patients with proved bronchiect
asis. Setting: The University of Texas Health Center at Tyler Hospital
and Clinics. Measurements and results: There were 38 men and 85 women
with a mean (+/-SD) age of 57.2+/-16.7 years; 55% were lifetime nonsm
okers, Diagnosis was confirmed with CTs of the chest in 56%, by bronch
ogram in 28%, and surgery with the remainder, Seventy percent of patie
nts gave a history of an antecedent potentially causative event for th
e bronchiectasis, usually pneumonia, Symptoms of bronchiectasis includ
ed chronic cough with the production of purulent sputum, hemoptysis, r
ecurrent fever, and pleurisy, The finding of crackles on chest examina
tion was the rule (70%) with wheezing present in 34% of the group, Pul
monary function studies documented airway obstruction to be present in
54% of the lifetime nonsmokers, The chest radiographs were abnormal i
n 91.3%, showing fibrotic stranding and infiltrates, A variety of path
ologic microbial flora, particularly Pseudomonas aeruginosa and other
opportunistic organisms, were isolated from the sputum, Patients who h
ad smoked had much the same picture as nonsmokers, although they had a
greater degree of airway obstruction. Conclusions: A characteristic c
linical picture of bronchiectasis emerges after review and evaluation
of these data, Knowledge of this picture should allow ready recognitio
n of the disease.