Bronchiectasis - a guide for primary care.

Abstract

While bronchiectasis not related to cystic fibrosis remains a significant cause of chronic respiratory disease in low to middle income countries, it has a lower profile in Australia. Nonetheless, there is increasing recognition that people living in Australia can present for the first time with noncystic fibrosis bronchiectasis at all stages of life. In addition, clinicians are often faced with the conundrum of minor changes consistent with bronchiectasis incidentally reported on computed tomography scan. This article aims to provide advice regarding when to suspect bronchiectasis, how to proceed with confirming or refuting a diagnosis, and the principles of management to minimise disease progression and manage the acute exacerbations, symptoms and associated disability and impaired quality of life. Delay in the diagnosis, investigation and management of bronchiectasis in both children and adults is common, and this delay has been shown to be associated with more rapid progression of disease. General practitioners have a key role in suspecting and accurately diagnosing and assessing bronchiectasis, discussing potential cases with specialist respiratory colleagues early and leading a multidisciplinary team to help patients with bronchiectasis manage their disease and minimise disability and premature death.