Blepharitis Disease
BASICS
- System(s) affected: Pulmonary
- Genetics: Associated with many conditions including some that are congenital or hereditary
- Incidence/Prevalence in USA:
- No reliable figures available
- Less common than it once was, probably due to more effective treatment of childhood respiratory infections
- Predominant age: Begins most often in early childhood, but symptoms may not appear until later in life
- Predominant sex: Male = Female
- Cough
- Sputum - copious and purulent
- Hemoptysis
- Wheezing
- Coarse or moist crackles
- Cyanosis
- Digital clubbing
- Dyspnea
- Barrel chest
- Emaciation
- Fatigue
- Fever
- Recurrent pneumonia
- Tachycardia
- Tachypnea
- Alpha-1-antitrypsin deficiency
- Allergic bronchopulmonary aspergillosis
- Bronchial obstruction
- Cystic fibrosis
- Dyskinetic cilia syndromes
- Hypogammaglobulinemia
- Inhaling noxious chemicals
- Kartagener's syndrome (situs inversus, sinusitis, immotile spermatozoa, bronchiectasis)
- Necrotizing pulmonary infections
- Pulmonary abscess
- Severe lung infection in childhood (measles, adenovirus, influenza, pertussis, or bronchiolitis)
- Tuberculosis
- Congenital immunodeficiency syndromes
- Chronic aspiration
- Rheumatic diseases
- Transplant graft rejection
- Repeated bouts of pneumonia
- Any chronic respiratory illness
- Retained foreign body
- Immunodeficiency
DIAGNOSIS
- Positive sputum culture (yields H. influenzae, Streptococcus pneumoniae, staphylococcal, klebsiella, pseudomonas, or anaerobes)
- Hypoxemia
- Leukocytosis, usually
- Serum immunoglobulins - check for hypogammaglobulinemia, IgE level helpful
Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A
- Bronchial dilation
- Inflamed bronchi
- Purulent bronchorrhea
- Necrosis of bronchial mucosa
- Peribronchial scarring
- Sweat test
- Skin test for aspergillus
- Bronchoscopy useful in locating bleeding site and to exclude adenoma or foreign body
- Ciliary biopsy with electron microscopy (EM)
- Pulmonary function tests show variable obstruction and restriction
- Sputum culture/sensitivity, AFB, fungus
- Bronchography
- For definitive diagnosis, to help determine extent, and if surgery contemplated
- Bronchial dilation, truncated
- Chest x-ray
- Can be normal
- Coarse lung markings - honeycomb/tram tracks
- Air-fluid level
- Cystic lesions
- Atelectasis
- CT scan
- Shows dilation of airways with signet rings
- High resolution CT is best to establish diagnosis and extent of disease
- Spiral CT helpful for questionable findings
- Fiberoptic bronchoscopy
- Recommended when disease is of recent onset or is unilateral
- May be combined with bronchography
- Obtain culture
TREATMENT
Outpatient except for possible surgery
- Airway clearance techniques
- Chest physical therapy
- Percussion
- Postural drainage
- Hydration
- Pulmonary rehabilitation to improve functional status
- Noninvasive positive pressure ventilation, nocturnal or chronic
- Bronchial artery embolization may be lifesaving for massive pulmonary hemorrhage
- Avoid cigarette smoking
- Bronchoscopy may be required for extraction of mucus or mycelial plugs, or if physiotherapy has failed
Segmental pulmonary resection for localized disease or refractory hemoptysis
As fully active as possible
No restrictions
Printed patient information available from: American Lung Association, 1740 Broadway, New York, NY 10019, (212)315-8700
FOLLOW UP
- Treat all pneumonias adequately
- Immunizations for viral illnesses (i.e., influenza)
- Immunization for pneumococcal pneumonia
- Routine childhood immunizations, e.g., pertussis, measles, Hib
- Genetic counseling if inherited etiology
- Recurrent pulmonary infections
- Pulmonary hypertension
- Secondary amyloidosis
- Cor pulmonale
- Brain abscess
- Massive hemoptysis
- Atelectasis
- Lung abscess
- Chronic. Surgery may be curative if disease localized.
- Average life expectancy - 55 years
MISCELLANEOUS
- Sinusitis
- Cor pulmonale
- Kartagener syndrome
- Cystic fibrosis
Pediatric: Cystic fibrosis and other congenital disorders
Geriatric: Elderly more likely to need hospitalization for treatment
Others: N/A
N/A
Conditions that may lead to bronchiectasis include severe pneumonia (especially measles, pertussis, adenoviral infections in children), necrotizing infections due to Klebsiella, staphylococci, influenza virus, fungi, mycobacteria, mycoplasma, bronchial obstruction from any cause (foreign body, carcinoma, enlarged mediastinal lymph nodes
N/A
Clinical Investigations
- Cardiology
- Dermatology
- General Destistry
- Cardiology
- Dermatology
ROLE OF HOMOEOPATHY
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