Managing bronchiectasis in adults in primary care: a clinical update.

Bronchiectasis is a condition where patients have symptoms of persistent or recurrent bronchial sepsis related to irreversibly damaged and dilated bronchi.1 The prevalence of bronchiectasis has risen by about 60% between 1994 and 2013 so that a GP practice population of 10 000 will have around 50 patients with the condition.2 Many patients with stable bronchiectasis and acute flare-ups can be managed in primary care. A diagnosis of bronchiectasis should be suspected when a patient presents with a recurrent or persistent (>8 weeks) cough with production of purulent or mucopurulent sputum.1 There should be a higher index of suspicion if there are coexistent factors, as outlined in Box 1. A full history and examination should be carried out to exclude other causes of chronic cough, such as chronic obstructive pulmonary disease (COPD), asthma, or lung cancer. Box 2 shows red-flag symptoms suggesting alternative serious pathology. | | || Box 1. Coexistent conditions raising the probability of bronchiectasis …