RespiratoryPending review

Bronchiectasis

Chronic infection and inflammation destroy the structural components of the bronchial wall, causing permanent, irreversible dilatation that pools mucus and perpetuates further infection, so the disease becomes a self-sustaining cycle of damage and re-infection rather than a single resolving illness.

In a nutshell

Chronic infection and inflammation permanently destroy the bronchial wall, causing irreversible dilatation. Dilated airways pool mucus, which becomes chronically colonised and perpetuates further inflammation and damage: a self-sustaining vicious cycle. Because the structural change cannot be reversed, treatment focuses on airway clearance and infection control rather than cure.

Classic presentation

Daily copious purulent sputum, recurrent chest infections and persistent coarse crackles, sometimes with haemoptysis, in a patient with a history of severe childhood chest infection or an underlying cause of impaired clearance or immunity.

Key points

  • Bronchial dilatation is permanent structural damage, unlike the reversible bronchospasm of asthma or the non-dilating fixed narrowing of COPD.

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Educational content pending clinical review. Not medical advice.