PANBRONCHIOLITIS (DIFFUSE)

  • An inflammatory lung disease whose cause is unknown.
  • A form of bronchiolitis, an inflammatory condition of the small passages of the lungs (bronchioles) that is severe and progressive.
    • “Diffuse” notes that the lesions appear throughout both lungs.
    • “Panbronchiolitis” refers to inflammation that can be see in all layers of the respiratory bronchioles.
  • Causes severe inflammation and nodule-like lesions of terminal bronchioles, chronic sinusitis, and intense coughing with large amounts of sputum production.
  • Classified as a form of “primary bronchiolitis”.
    • Underlying cause of bronchiolitis stems from or is limited to the bronchioles.

Symptoms of DPB include:

  • Chronic sinusitis (inflamed paranasal sinuses).
  • Wheezing, crackles (respiratory sounds made by obstructions such as phlegm and secretions in the lungs).
  • Dyspnea (shortness of breath).
  • Severe cough that yields large amounts of sputum (coughed-up phlegm).
    • Pus may be found in the sputum, and affected individuals may have fever.

Signs of progression include:

  • Dilation (enlargement) of the bronchiolar passages.
  • Hypoxemia (low levels of oxygen in the blood.

If DPB is left untreated, bronchiectasis will occur.

  • Characterized by dilation and thickening of the walls of the bronchioles, inflammatory damage to respiratory and terminal bronchioles, and pooling of mucus in the lungs.

DPB is related to:

  • Progressive respiratory failure.
  • Hypercapnia (increased levels of carbon dioxide in the blood).
  • Pulmonary hypertension (high blood pressure in the pulmonary vein and artery.
  • Cor pulmonale (dilation of the right ventricle of the heart, or “right heart failure”).

DIAGNOSIS

Physician may do/request:

  • History & Physical Exam
  • Other Additional tests such as:
    • Lung biopsy
    • High-Resolution Computed Tomography (HRCT) scan
    • Chest X-ray
    • Arterial Blood Gas
    • Complete Blood Count
    • Culture

 

RECOMMENDED MEDICATIONS

Macrolide antibiotics (erythromycin, Clarithromycin or roxithromycin).

  • Daily oral administration of erythromycin for two to three years.

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