Dear Friends, We get BRONCHIECTASIS quite often in our day to day practice.. AN UPDATE ON CAUSES AND MANAGEMENT IS HERE FOR YOU… CAUSES OF BRONCHIECTASIS : (1)Primary infections (2)Bronchial obstruction (3)Aspiration (4)Cystic fibrosis (5)Primary ciliary dyskinesia (6)Allergic bronchopulmonary aspergillosis (7)Immunodeficiency states (8)Congenital anatomic defects (9)Connective-tissue disorders (10)Alpha1-antitrypsin (AAT) deficiency (11) Autoimmune diseases (12)Idiopathic inflammatory disorders (13)Autosomal dominant polycystic kidney disease (14)Traction from other processes (15)Toxic gas exposure etc. PRIMARY INFECTIONS …. Details… Bronchiectasis may be the sequela of a variety of necrotizing infections that are either inadequately treated or not treated at all. Typical offending organisms are follows…. (1)MYCOBACTERIUM TUBERCULOSIS (2)KLEBSIELLA SPECIES (3)STAPHYLOCOCCUS AUREUS (4)MYCOPLASMA PNEUMONIAE (5)NON TUBERCULOUS MYCOBACTERIAL (6)MEASLES VIRUS (7)PERTUSSIS VIRUS (8)INFLUENZA VIRUS (9)HERPES SIMPLEX VIRUS (10)CERTAIN TYPES OF ADENOVIRUS (11) RESPIRATORY SYNCTITIAL VIRUS infection in the childhood etc. In established bronchiectasis, same or different organisms may colonize the damaged bronchi and may cause infectious exacerbations. The organisms most commonly responsible include… Haemophilus species (47-55% ) and Pseudomonas species (18-26%) MANAGEMENT (1)Antibiotics and chest physiotherapy are the mainstays of treatment. (2)Bronchodilators (3) ICS if associated obstructive airway disease. (4)Dietary supplementation (5)Oxygen (reserved for hypoxemic patients with severe disease) (6)Hospitalization for severe exacerbations (7)Surgical therapies Surgical resection of involved bronchiectatic sites is an important adjunct to therapy for patients with focal disease that is poorly controlled by antibiotics. Hope.. Above update will be HELPFUL to you Thanks Dr K N Poddar

19 y.o man with recurrent upper and lower respiratory infections. Bronchoscopy was just completed. Seminal Fluid Comment: ONLY MOTILITY ORDERED FLUID VOLUME. . . <0.5 L (1.5-5.0) mL SFL SPERM M/100 . . . 60% (NORM>50%) Result Comment: 50% RAPID AND 50% SLUGGISH Result Comment: PERIOD OF ABSTINENCE FROM EJACULATION - 2 DAYS. Help in diagnose the condition and managing the case.

62 y male C/o severe dysnea since two hours Known case of COPD / DM/HTN Interpret CXR and give differential diagnosis . On arrival BP-180/110 Pulse -136 RR - 34 ABG - WNL

diagnose this characteristics appearance in ct thorax

72 female presented with cough wirh mucus expectations,fever and dyspnea since a week,non responding to antibiotics and bronchodilators. spo2 88%. BP 150/90mmhg. HR 122/min. RV neg. ESR 60mm. Rtrt mid and basal bronchial breathing heard. Routine lab reports, cxray,echo and ct thorax images displayed. plz guide.