Lung-Pulmonology

What is Bronchiectasis?

Patients with bronchiectasis cannot clear bacteria and mucus from their lungs because of a widening and inflammation of their airways.

Symptoms of Bronchiectasis

If left untreated, symptoms may progress to include worsening shortness of breath, deteriorating quality of life, and heart failure. If you think you may have this disease, Mount Sinai’s pulmonologists are experts in its diagnosis. Symptoms of bronchiectasis include: 

  • Cough, which may produce mucus (in the case of infections, the mucus may be discolored, foul-smelling, and contain blood)
  • Shortness of breath
  • Wheezing
  • Weight loss
  • Fatigue
  • Chronic sinusitis

Causes of Bronchiectasis

Bronchiectasis can be congenital (present from birth) or acquired (develop as the result of a cause such as an infection). The most common causes of bronchiectasis are:

  • Infections: Infections that could lead to bronchiectasis include viral infections (such as measles or influenza), bacterial infections (such as staphylococcus aureus), mycobacterial infections (such as tuberculosis), and fungal infections (such as histoplasmosis).
  • Immune Diseases: Patients suffering from immune deficiencies are more likely to experience recurrent lung infections, which can cause airway damage that leads to bronchiectasis.
  • Aspiration: Inhalation of materials from the mouth or stomach into the lungs can inflame airways, leading to bronchiectasis. Aspiration may be caused by conditions such as impaired swallowing, which may allow food or saliva into the lungs, or gastroesophageal reflux disease (GERD), which happens when the valve between the esophagus and stomach malfunctions, allowing stomach contents to flow up into the esophagus and enter the lungs.
  • Autoimmune Diseases: Rheumatologic, autoimmune, or connective tissue conditions including rheumatoid arthritis or lupus could cause bronchiectasis.
  • Genetic Diseases: Conditions such as cystic fibrosis, primary ciliary dyskinesia, and alpha1 antitrypsin deficiency can cause recurrent lung infections that lead to bronchiectasis.
  • Airway Obstructions: Obstructions resulting from a growth like a tumor or a disease such as chronic obstructive pulmonary disease (COPD) could trap mucus and infections causing airway damage the leads to bronchiectasis.

Screening & Diagnosis

In order to evaluate a patient for bronchiectasis, your doctor will perform a thorough physical examination and take a comprehensive medical history. Tests for bronchiectasis often include the following:

  • Chest CT scan of the lungs
  • Pulmonary function tests, which are breathing tests that determine the presence and severity of abnormal airflow from the lungs
  • Specific diagnostic or screening tests for the possible underlying conditions that could cause bronchiectasis

Following diagnosis, your doctor will design an individualized treatment plan to meet your needs.

What is NTM?

Nontuberculous mycobacteria (NTM) are types of germs found in water and soil. While they do not usually make people sick,  NTM can cause infections in some patients, particularly those with an underlying illness or compromised lung function, bronchiectasis.

The NTM infection can become chronic, with a severe case requiring ongoing treatment, but NTM is not contagious.

Symptoms of NTM

The symptoms of an NTM infection may develop gradually and include the following:

  • Fever
  • Cough (which may include blood)
  • Loss of appetite and weight loss
  • Night sweats
  • Fatigue

Diagnosis of NTM

In order to diagnose a nontuberculous mycobacteria (NTM) infection, your healthcare provider will perform a thorough physical examination and take your medical history. Tests for NTM often include the following:

  • CT scan of the chest
  • Lab tests, such as a sputum culture
  • Bronchoscopy

If you receive a diagnosis of NTM, your doctor will develop an individualized treatment plan for you to meet your needs.