Case history
Case history #1
A 55-year-old woman presents for evaluation of a chronic cough, productive of thick, yellow sputum that sometimes becomes blood-tinged. She has experienced recurrent episodes of fever associated with pleuritic chest pain. She states that she is embarrassed by the persistent, intractable nature of her cough and has been prescribed multiple courses of antibiotics. Over the last 5 years, she has developed shortness of breath with exertion. Her past medical history is significant for pneumonia as a child and sinus polyps during adulthood for which she has had surgery.
Case history #2
A 7-year-old boy is brought for review by his parents who are concerned about a persistent, wet cough that is affecting his sleep. His teachers report that he is tired during the school day. Since starting childcare aged 1 year old, he has experienced recurrent lower respiratory tract infections, which have resulted in several hospital admissions. His history is notable for preterm birth at 34 weeks. On examination a wheeze is present.
Other presentations
Patients may develop wheezing in addition to increased cough with sputum production, mimicking chronic bronchitis or asthma. Occasionally, patients may present with haemoptysis. This may be caused by erosion of the airway wall, chronic inflammation in the context of enlarged bronchial arteries, and bronchopulmonary anastomoses that are known to occur in bronchiectasis.[5]
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