Diagnosis of Bronchiectasis
Diagnosis of bronchiectasis involves a combination of medical history, physical examination, imaging, and lab tests. A clear diagnosis of bronchiectasis allows healthcare providers to determine the severity of the disease, identify underlying causes, and begin tailored treatment to reduce long-term damage.
The process begins with a detailed history. Doctors will ask about the duration and pattern of symptoms — especially coughing, sputum production, breathlessness, and history of chest infections or childhood illnesses. A history of tuberculosis, pneumonia, or asthma is often relevant.
A physical examination may reveal crackles or wheezing sounds when listening to the lungs with a stethoscope. Doctors also look for signs like finger clubbing, chronic infection, or general fatigue.
High-resolution CT (HRCT) scans are the gold standard for diagnosis. Doctors use these detailed images to confirm whether the airways are abnormally widened, thickened, or filled with mucus—classic signs of bronchiectasis. Chest X-rays may be done initially but are less sensitive.
Lung function tests (spirometry) assess how well the lungs are working. These tests help determine if airway obstruction is present and monitor progression over time.
Diagnosis of bronchiectasis
Sputum cultures identify which bacteria or fungi are present in the mucus. This guides antibiotic treatment, especially during infections. In some cases, doctors test sputum for tuberculosis or resistant organisms like Pseudomonas aeruginosa.
Blood tests may check for signs of infection, immune system function, and underlying conditions like autoimmune diseases or allergic responses (e.g. IgE levels in allergic bronchopulmonary aspergillosis).
In children or patients with suspected cystic fibrosis, doctors may perform a sweat chloride test or genetic testing to confirm the diagnosis.
An accurate diagnosis of bronchiectasis allows doctors to create the right treatment plan, prevent repeated infections, preserve lung function, and improve quality of life.
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