Abstract

EVALUATION OF CLINICAL, DIAGNOSTIC AND TREATMENT OUTCOME IN ACUTE EXACERBATION OF BRONCHIECTASIS IN ADULTS

Author(s): Vinod Kolla1, Majeed Pasha2, Mohammed Parveez Noorullah3, Vivek Gundappa4, Pradeep Ishwarappagol5, Niaz Farhat6

BACKGROUND
Bronchiectasis is defined as “abnormal and permanent dilatation of one or more bronchi due to weakening or destruction of the muscular and elastic components of the bronchial walls.” HRCT has become the gold standard to diagnose bronchiectasis. Antibiotics and chest physiotherapy are main forms of management. The aim of the study is to study the outcome of treatment in acute exacerbation of bronchiectasis in adults.
MATERIALS AND METHODS
This study was done prospectively in the Department of Respiratory Medicine in Rajarajeswari Medical College and Hospital from November 1, 2015, to April 30, 2017. Out of 55 cases admitted during the study period, 44 cases (10 females) were eligible for participation in the study. 2 cases of Kartagener’s syndrome under follow up in our department for past 3 years were included. Flexible bronchoscopy was done in 31 patients.
RESULTS
Cough with sputum was the commonest symptom. Breathlessness was documented in 32 patients. Arterial blood gas analysis was abnormal in 29 patients. Haemoptysis in 13 cases. History of antituberculous therapy was present in 34 patients. Digital clubbing was present in 30 patients. Pedal oedema was documented in 14 cases. Associated cultures were positive in 28 cases.
CONCLUSION
The most frequent form of bronchiectasis is post-tuberculous. Pseudomonas aeruginosa is the most frequently isolated bacteria. The most frequent concomitant disease in bronchiectasis is COPD. Piperacillin/tazobactum is the most effective antibiotic for initial empirical treatment of acute exacerbations of bronchiectasis.