Characterisation of the onset and presenting clinical features of adult bronchiectasis

Respir Med. 2006 Dec;100(12):2183-9. doi: 10.1016/j.rmed.2006.03.012. Epub 2006 May 2.

Abstract

Background: There is little information available on the features of initial presentation of bronchiectasis and documentation of the onset and progress of symptoms leading up to this. Therefore a study was performed on a large cohort of adult patients presenting to Monash Medical Centre (MMC) to survey the course of their disease up to the time of diagnosis.

Objectives: To characterise the onset and presenting clinical features of bronchiectasis in adults.

Methods: A cross-sectional study of 103 adults presenting to a tertiary referral hospital with newly diagnosed bronchiectasis. Clinical features of bronchiectasis and results of spirometry, sputum microbiology and radiology were assessed and correlated.

Results: Most patients had idiopathic bronchiectasis (74%) and did not have other significant disease. The dominant symptom was chronic productive cough present in 98% of patients with other important symptoms being chronic rhinosinusitis (70%), dyspnoea (62%), and fatigue (74%). Most patients had had a chronic productive cough for over 30 years prior to diagnosis and over 80% of patients had chronic respiratory symptoms from childhood. The dominant finding on physical examination was the presence of crackles which were generally bi-basal. Spirometry showed mild airway obstruction with an average forced expiratory volume in 1s of the cohort of 76% predicted. Radiologic imaging generally showed multilobar disease (80%).

Conclusions: The typical profile of bronchiectasis in this group of patients was of longstanding productive cough, rhinosinusitis and fatigue in non-smokers with crackles on chest auscultation.

MeSH terms

  • Asthma / complications
  • Asthma / physiopathology
  • Bronchiectasis / complications*
  • Bronchiectasis / physiopathology
  • Chronic Disease
  • Cohort Studies
  • Cough / complications
  • Cough / physiopathology
  • Cross-Sectional Studies
  • Dyspnea / complications
  • Dyspnea / physiopathology
  • Fatigue / complications
  • Fatigue / physiopathology
  • Female
  • Humans
  • IgG Deficiency / complications
  • IgG Deficiency / physiopathology
  • Male
  • Middle Aged
  • Pneumonia / complications
  • Pneumonia / physiopathology
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Respiratory Function Tests / methods
  • Respiratory Sounds / physiopathology
  • Rhinitis / complications
  • Rhinitis / physiopathology
  • Sinusitis / complications
  • Sinusitis / physiopathology
  • Smoking / physiopathology
  • Sputum / microbiology