Bronchiectasis
Basics
Description
Bronchiectasis is an irreversible syndrome with symptoms of chronic productive cough and recurrent exacerbations and with characteristic findings on cross-sectional imaging of bronchial wall dilation and thickening.
Epidemiology
Prevalence
- Overall estimated prevalence of bronchiectasis in the United States is 701 per 100,000 (1).
- Prevalence is higher among women than men and increases with age.
Etiology and Pathophysiology
- Bronchiectasis often arises as a complication of inherited or acquired disease states but may arise as an isolated diagnosis.
- Vicious cycle hypothesis (1):
- An initial pulmonary insult causes airway inflammation, dysfunction, and structural disease.
- Dysfunctional airways are further impaired in their ability to clear infections.
- A pattern of lung damage/inflammation and progressive airway dysfunction is established, leading to clinical decline.
- Neutrophil extracellular traps (NETs) levels and neutrophil elastase activity correlate with disease activity and may serve as potential therapeutic targets (1).
General Prevention
- Routine immunization against respiratory infections (pertussis, measles, Haemophilus influenzae type B [HIB], influenza, and Streptococcus pneumonia).
- Early recognition and treatment of respiratory disease, inflammatory disease, and other predisposing conditions
- Genetic counseling for patients with inheritable conditions which predispose to bronchiectasis who wish to conceive
- Encourage and support smoking cessation in all patients who smoke
Commonly Associated Conditions
- Many cases are idiopathic, and bronchiectasis may be an isolated pulmonary diagnosis.
- Acquired conditions associated with bronchiectasis:
- Pneumonia
- GERD
- Asthma/chronic obstructive pulmonary disease (COPD)
- Rheumatologic conditions (rheumatoid arthritis, IBD)
- Tuberculosis (TB)
- Allergic bronchopulmonary aspergillosis (ABPA)
- Chronic rhinosinusitis
- Focal airway obstruction
- Inherited conditions associated with bronchiectasis:
- Cystic fibrosis
- Primary ciliary dyskinesia
- Congenital abnormalities of the airways (e.g., tracheobronchomalacia, Mounier-Kuhn syndrome)
- α1-Antitrypsin deficiency
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Citation
Domino, Frank J., et al., editors. "Bronchiectasis." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116092/all/Bronchiectasis.
Bronchiectasis. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116092/all/Bronchiectasis. Accessed December 3, 2024.
Bronchiectasis. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116092/all/Bronchiectasis
Bronchiectasis [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 03]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116092/all/Bronchiectasis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Bronchiectasis
ID - 116092
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116092/all/Bronchiectasis
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -