Initial workup-bronchiectasis

• H&P: cough, dyspnea, copious sputum production, ±hemoptysis, inspiratory “squeaks”

• CXR: scattered or focal; rings of bronchial cuffing; “tram track” of dilated, thick airways

• PFTs: obstructive; chest CT: airway dilation & thickening ± cystic Δs, infiltrates, adenopathy

Chronic infxns (eg, MTb, ABPA)

Chronic cough, freq/persist infiltrate, refract asthma (ABPA)

Sputum cx (incl mycobact, fungal), ± bronch/BAL, IgE & eos (ABPA)

1° ciliary dyskin

Sinusitis, infertility, otitis

Dynein mutations

Immunodefic

Recurrent infxns often as child

IgA, IgG, IgM, IgG subclasses

RA, Sjogren, ANCA

Resp sx may precede joint sx

RF, CCP, SS-A, SS-B, ANCA

IBD

Not relieved by bowel resection

Colonoscopy, biopsy

α1-AT deficiency

Lower lobe emphysema

α1-AT level and genotype

Anatomic

R middle lobe synd. from sharp takeoff, foreign body aspiration

Bronchoscopy