Merck Manual

Please confirm that you are a health care professional

honeypot link
Factors Predisposing to Bronchiectasis

Factors Predisposing to Bronchiectasis

Category

Examples and Comments

Infections

Bacterial

Haemophilus influenzae

Pseudomonas aeruginosa

Moraxella catarrhalis

Staphylococcus aureus

Streptococcus pneumoniae

Mycoplasma pneumoniae

Bordetella pertussis

Klebsiella species

Fungal

Aspergillus species

Histoplasma capsulatum

Mycobacterial

Mycobacterium tuberculosis

Nontuberculous mycobacteria

Viral

Adenovirus

Herpes simplex virus

Influenza

Measles

Respiratory syncytial virus

Congenital disorders

If severe, can cause bronchiectasis

Ciliary defects

Can cause bronchiectasis, sinusitis, otitis media, and male infertility

50% of patients with primary ciliary dyskinesia (PCD) have situs inversus

Kartagener syndrome (clinical triad of dextrocardia, sinus disease, situs inversus)

Causes viscous secretions due to defects in sodium and chloride transport

Often complicated by P. aeruginosa or S. aureus colonization

Immunodeficiencies

Primary

Chronic granulomatous disease

Complement deficiencies

Hypogammaglobulinemia, particularly common variable immunodeficiency

Secondary

Hematologic malignancy

Immunosuppressants

Airway obstruction

Cancer

Endobronchial lesion

Extrinsic compression

Due to tumor mass or lymphadenopathy

Foreign body

Aspirated or intrinsic (eg, broncholith)

Mucoid impaction

Allergic bronchopulmonary aspergillosis

Postoperative

After lobar resection, due to kinking or twisting of remaining lobes

Connective tissue and systemic disorders

Commonly causes bronchiectasis (frequently subclinical), more often in men and in patients with long-standing rheumatoid arthritis

Bronchiectasis possibly due to increased viscosity of bronchial mucus, which leads to obstruction, poor clearance, and chronic infection

Bronchiectasis in up to 20% of patients via unclear mechanisms

Bronchopulmonary complications occurring after onset of inflammatory bowel disease in up to 85% and before onset in 10 to 15%

Bronchiectasis more common in ulcerative colitis but can occur in Crohn disease

Congenital structural defects

Lymphatic

Yellow nail syndrome

Tracheobronchial

Williams-Campbell syndrome (cartilage deficiency)

Tracheobronchomegaly (eg, Mounier-Kuhn syndrome)

Vascular

Pulmonary sequestration (a congenital malformation in which a nonfunctioning mass of lung tissue lacks normal communication with the tracheobronchial tree and receives its arterial blood supply from the systemic circulation)

Toxic inhalation

Ammonia

Chlorine

Nitrogen dioxide

Direct airway damage altering structure and function

Other

Transplantation

May be secondary to frequent infection due to immunosuppression

Diffuse panbronchiolitis

Rare syndrome involving bronchiolitis and chronic sinusitis

Obstructive lung disease

May occur with advanced chronic obstructive pulmonary disease (COPD) or asthma

Chronic aspiration

Due to severe gastroesophageal reflux disease or swallowing dysfunction, most commonly in the lower lobes

Data from Barker, AF: Bronchiectasis. The New England Journal of Medicine 346:1383–1393, 2002 and O'Donnell AE: Medical management of bronchiectasis. J Thorac Dis 10 (Suppl 28): S3428–S3435, 2018.