Definition and epidemiology (NEJM 2002;346:1383)

  • Obstructive airways disease of bronchi and bronchioles, chronic transmural inflammation w/ airway dilatation and thickening, collapsibility, mucus plugging w/ impaired clearance

Initial workup

  • H&P: cough, dyspnea, copious sputum production, ±hemoptysis, inspiratory “squeaks”
  • CXR: scattered or focal; rings of bronchial cuffing; “tram track” of dilated, thick airways
  • PFTs: obstructive; chest CT: airway dilation & thickening ± cystic Δs, infiltrates, adenopathy
Etiology Other Features Diagnostic Testing
Chronic infxns (eg, MTb, ABPA) Chronic cough, freq/persist infiltrate, refract asthma (ABPA) Sputum cx (incl mycobact, fungal), ± bronch/BAL, IgE & os (ABPA)