bronchiectasis jj
TRANSCRIPT
-
8/4/2019 BRONCHIECTASIS jj
1/18
BRONCHIECTASISCOMPLICATIONS & DIFFERENTIAL
DIAGNOSIS
JJ.JENSON
-
8/4/2019 BRONCHIECTASIS jj
2/18
COMPLICATIONS Hemoptysis
Lung abscess
Pyothorax
Cor pulmonale
Recurrent pnemonia
Cavity formation
-
8/4/2019 BRONCHIECTASIS jj
3/18
HEMOPTYSIS
MECHANISM:
Vascular enlargement of dilated bronchialvessels resulting in the erosion of the adjacentbronchial arterioles &pulmonary capillariesresults in massive hemoptysis
Management:Blood transfusion,oxygen therapy
-
8/4/2019 BRONCHIECTASIS jj
4/18
LUNG ABSCESS
Mechanism:
Chronic bronchial inflammation secondary toinappropriate clearance of various microorganisms leading to infection which results inLung abscess
Organisms:Anaerobes,Staphylococci,Psuedomonas
Clinical ftrs:fever,cough with purulent sputum
-
8/4/2019 BRONCHIECTASIS jj
5/18
Contd..
Hemoptysis may be associated
Management:Application of antibiotics,posturaldrainage,
-
8/4/2019 BRONCHIECTASIS jj
6/18
PYOTHORAX
Mechanism:
Pus getting collected in the plueral cavity due torepeated infections leads to pyothorax
Symptoms:cough,fever,chest pain,shortness ofbreathing
Diagnosis:Pus culture&tests for antibioticsensitvity
Treatment:Thoracocentesis
-
8/4/2019 BRONCHIECTASIS jj
7/18
CORPULMONALE
Enlargement of right ventricle with or withoutfailure secondary to disease of lung&pulmonarycirculation
Clinical ftrs:Palpitation,dyspnea,edema
Treatment:Diuretics,vasodilators,control of
infection
-
8/4/2019 BRONCHIECTASIS jj
8/18
RECURRENT PNEMONIA
Exudative solidification of lung tissue
Causes:Foreign bodies
Management:Sputum examination,bloodculture,serology(mycoplasma,chlamydia)
Pnuemococcal:PenicillinG 50,000 units/kg/day
can be given intravenously in divided doses for aweek to ten days
-
8/4/2019 BRONCHIECTASIS jj
9/18
CAVITY FORMATION
Results due to the tuberculous involvement ofbronchial wall
Mechanism:it occurs in post-primarytuberculous patients due to cicatrialbronchostenosis which leads to destruction of
lung parenchyma Apical&posterior segments of the upper lobe is
involved
-
8/4/2019 BRONCHIECTASIS jj
10/18
RARE COMPLICATIONS
Septicemia
Amyloidosis
Respiratory failure
Metastatic abscess to the brain
-
8/4/2019 BRONCHIECTASIS jj
11/18
DIFFERENTIAL DIAGNOSIS based onSYMPTOMS
COUGH WITH SPUTUM
CRACKLES
-
8/4/2019 BRONCHIECTASIS jj
12/18
DD for COUGH WITH SPUTUM
Based on 1)Amount of sputum production
2)Colour of the sputum
-
8/4/2019 BRONCHIECTASIS jj
13/18
Amount of Sputum
Sudden production of large amount of purulentsputum on a single occasion-rupture of lung
abscess
Large volume of watery sputum with a pinkishtinge-acute pulmonary edema
-
8/4/2019 BRONCHIECTASIS jj
14/18
COLOUR&TYPE OF SPUTUM
Green,purulent sputum Pnuemonia,Cysticfibrosis
Yellow,purulent sputum-Acutebronchopulmonary infection
Mucoid sputum-Chronic bronchitis
Pink,frothy,serous sputum-Acute pulmonaryedema
Rusty red sputum-Pnuemococcal pnemonia
-
8/4/2019 BRONCHIECTASIS jj
15/18
CRACKLES
Crackles are defined as non-musical,interruptedadded sounds of short duration,explosive in
nature
TYPES-1)Fine crackles
2)Coarse crackles
Fine crackles
sign of parenchymal infiltration Apex of lung-pulmonary tuberculosis
Diffuse fine crackles-Pnuemonia
-
8/4/2019 BRONCHIECTASIS jj
16/18
COARSE CRACKLES
Coarse leathery crackles heard in base of lung-Bronchiectasis
If heard diffusely all over lung-Cysic fibrosis
Bronchitis
Moist bubbling crackles-pulmonary edema
-
8/4/2019 BRONCHIECTASIS jj
17/18
INSPIRATORY CRACKLES
Early inspiratory crackles-Bronchiolitis
Mid inspiratory crackles-Bronchiectasis
Late inspiratory crackles-pulmonary edema
EXPIRATORY CRACKLES-chronic bronchitis
-
8/4/2019 BRONCHIECTASIS jj
18/18
THANK
U