pulmonary disorders
Bronchiectasis
Symptoms and Signs of Bronchiectasis
Symptoms characteristically begin insidiously and gradually worsen over years, accompanied by episodes of acute exacerbation. The most common presenting symptom is chronic cough that produces thick, tenacious, often purulent sputum. Dyspnea and wheezing are common, and pleuritic chest pain can develop. In advanced cases, hypoxemia and right-sided heart failure due to Pulmonary Hypertension may increase dyspnea. Hemoptysis, which can be massive, occurs due to airway neovascularization. Acute exacerbations are common and frequently result from new or worsened infection. Exacerbations are marked by a worsening cough and increases in dyspnea and the volume and purulence of sputum. Low-grade fever and constitutional symptoms (eg, fatigue, malaise) may also be present. Halitosis and abnormal breath sounds, including crackles, rhonchi, and wheezing, are typical physical examination findings. Digital clubbing is uncommon but may be present. Chronic rhinosinusitis and nasal polyps may be present, particularly in patients with CF or primary ciliary dyskinesia. Lean body mass commonly decreases, possibly due to inflammation and cytokine excess and, in patients with CF, malabsorption. 