Just got diagnosed with Bronchiectasis........

2 weeks ago I went to the hospital for chest pains. They did ECG, Xray, general blood work to check for damage to heart vessels and a CT Scan. My D-Dimer test came back positive but the Ct Scan showed no signs of pulmonary embolism. The pleural spaces were clear, oxygen levels were good. Heart and lungs were normal Trachea was normal except the dr found a little scarring in the upper lobe. The report said, "Trace upper lobe bronchiectasis" - Mild Bronchiectasis. The emergency room dr said that its nothing I should be worried about now but it is a bit unusual to have this on the upper lobes on both sides. He asked me if I ever had Pneumonia as a child.

I have been coughing for almost 3 years now on and off. little or no sputum. did xrays twice in the past 3 years and they came back normal. I am a smoker but since the day I got my CT Scan I have quit and the coughing has stopped. I only cough once or twice a day no sputum comes up.

Before this i was generally healthy. I would get sick a few times a year. usually the same thing...sore throat, inflammed throat, light fever, dizzyness. usually would go away after a few days without medication.

Since my CT Scan I have been stressing out a lot, very anxious trouble sleeping, nervous. I have had a sore throat for 7 days now. (was wondering if it could be from quitting smoking) It is okay during the day but gets bad at night. I even got an eye infection...most likely conjunctivitis. I am taking antibiotic eye drops and it has gotten a lot better now.

I have been playing "Dr Google" online and reading tons of articles and different websites about this illness but this has just made me more nervous and scared. The wikipedia article says that AIDS is the leading cause of bronchiectasis and upper lobe is usually linked to tuberculosis or CF (what else can cause mild bronchiectasis in the upper lobes?) I am worried after reading about MAC infection

[David Tinkelman, M.D.]

Your concern regarding the specificity of upper lobe bronchiectasis is warranted  The pattern and distribution of abnormalities revealed by high-resolution CT in patients with bronchiectasis are influenced by the underlying cause. Bilateral, predominantly upper lobe, bronchiectasis is seen most commonly in patients with cystic fibrosis and allergic bronchopulmonary aspergillosis, unilateral upper lobe predominance in patients with tuberculosis.

Allergic bronchopulmonary aspergillosis  (above)– Aspergilla is a fungous that may cause infection or an allergic response.  It occurs not uncommonly with asthma.  As you note, MAC has also been causally related to upper lobe bronchiectasis.

Whatever the cause of your bronchiectasis, it may have begun a long time ago.”  For me, that raises the possibility that your underlying lung disease, might well be cystic fibrosis (just previously undiagnosed).  Or as suggested, a residual of infection in childhood or infancy. To my knowledge, there is no relationship between your bronchiectasis and the pectus.  

The import of the diagnosis of bronchiectasis depends on the extent of it (localized to one portion of lung as opposed to being present in many locations in both lungs) and the treatability of it (medically or surgically treatable).  Your cough may or may not be related to the CT findings.  The most important questions to be answered is, are the upper lobe changes reflective of an active, presumably infectious, process or are they reflective of a prior (TB or other) infection, currently inactive?  And, secondly, does your cough of 3 years causally related to the upper lobe disease and/or scarring, or on the basis of other disease?  In your case, I would suspect that cigarette smoking has been a major contributor to your cough, that belief supported by the response of your cough to smoking cessation.

Now that you have stopped smoking I urge you to never smoke again.  As far as the bronchiectasis, if your cough remains minimal as described, it would probably be appropriate to follow the upper lobe lesions with limited (to the upper lobes) scanning to confirm that the bronchiectasis is stable.

Good luck

[davidzar]

I am 29 years old. I was born with pectus excavatum (sunken chest) and I know this can sometimes lead to pulmonary problems, could it be linked to bronchiectasis?

Also my sister and I both have "plugged noses" we used to use nasal spray as kids to open up the sinuses. I do blow my nose alot in the mornings and I have always had stuff come up..

I have never had an allergy test done

[davidzar]

Hi Dr Tinkelman,

As far as I know, I have never had TB. Can childhood pneumonia or flu also cause bronch in the upper lobes?

Im just wondering what is the next step for me now.

Will I be given inhalers or other medications? Also, will I only have to take antibiotics when there is an active infection?

Finally, does bronchiectasis spread?

Thank You for your Response,

David

[Suze17]

Hi I would be grateful if anyone can help me, I am going out my mind with worry.  I have been for a chest xray and it came back saying I had a well defined 5mm opacity nodule on my lateral right lung mid zone, initially they said it was a possibility of a granuloma due to old or healed TB. I asked to be referred for a CT scan which I had yesterday, I haven't got a copy of the report as yet but got the results over the phone and they said something about a cluster of nodules on my lung and its definitely not TB, what else could this possibly be?  I was a smoker but have given up for the past 2 weeks I was told 2 years ago I had asthma and have been using inhalers although for the past 3 months I have never had any symptoms of asthma and have never felt healthier but very scared as to what this can be, can anyone help??