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Inicio Medicina Clínica (English Edition) Bronchiectasis not due to cystic fibrosis
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Vol. 163. Issue 2.
Pages 81-90 (July 2024)
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Vol. 163. Issue 2.
Pages 81-90 (July 2024)
Review
Bronchiectasis not due to cystic fibrosis
Bronquiectasias no debidas a fibrosis quística
Rosa Giróna, Rafael Golpeb, Miguel Ángel Martínez-Garcíac,d,
Corresponding author
mianmartinezgarcia@gmail.com

Corresponding author.
a Servicio de Neumología, Hospital Universitario La Princesa, Madrid, Spain
b Servicio de Neumología, Hospital Universitario Lucus Augusti, Lugo, Spain
c Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
d CIBER de Enfermedades Respiratorias, ISCIII, Madrid, Spain
Article information
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Figures (2)
Tables (4)
Table 1. Radiological diagnostic criteria for bronchiectasis according to Naidich.
Table 2. Validated severity scales.
Table 3. Causes of bronchiectasis.
Table 4. Chronic pharmacological treatment in patients with bronchiectasis: types of drugs and recommendations for use of the main bronchiectasis treatment guidelines.
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Abstract

Bronchiectasis is a clinical-radiological condition composed of irreversible bronchial dilation due to inflammation and infection of the airways, which causes respiratory symptoms, usually productive cough and infectious exacerbations. Bronchiectasis can have multiple causes, both pulmonary and extrapulmonary, and its clinical presentation is very heterogenous. Its prevalence is unknown, although up to 35%–50% of severe COPD and 25% of severe asthma present them, so their underdiagnosis is evident. Chronic bacterial bronchial infection is common, and Pseudomonas aeruginosa is the pathogen that has been found to imply a worse prognosis. Treatment of bronchiectasis has three fundamental characteristics: it must be multidisciplinary (involvement of several specialties), pyramidal (from primary care to the most specialized units) and multidimensional (management of all aspects that make up the disease).

Keywords:
Bronchiectasis
Bronchial infection
Pseudomonas aeruginosa
Macrolides
Inhaled antibiotics
Resumen

Las bronquiectasias se consideran como un cuadro clínico-radiológico compuesto por la dilatación bronquial irreversible debido a la inflamación e infección de la vía aérea, lo que causa en el paciente unos síntomas respiratorios, habitualmente tos productiva y agudizaciones de perfil infeccioso. Las bronquiectasias pueden estar generadas por múltiples causas, tanto pulmonares como extrapulmonares, lo que les confiere una gran heterogeneidad en su presentación clínica. Su prevalencia es desconocida si bien hasta un 35-50% de la EPOC grave y 25% del asma grave las presentan, por lo que su infradiagnóstico es evidente. La infección bronquial crónica bacteriana es frecuente, siendo Pseudomonas aeruginosa el microorganismo que ha demostrado provocar un peor pronóstico. El tratamiento de las bronquiectasias presenta tres características fundamentales: debe ser multidisciplinar (implicación de varias especialidades), piramidal (desde atención primaria hasta las unidades más especializadas) y multidimensional (manejo de todos los aspectos que conforman la enfermedad).

Palabras clave:
Bronquiectasias
Infección bronquial
Pseudomonas aeruginosa
Macrólidos
Antibióticos inhalados

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