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Bronchiektasen

Bronchiectasis

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Zusammenfassung

Durch die Entwicklung und frühzeitige Einleitung antibiotischer Therapien und die Entwicklung von Impfstoffen sind Bronchiektasenerkrankungen seltener geworden. Betroffen sind meist die mittelgroßen Bronchien auf Segment- und Subsegmentebene. Eine chronische Entzündungsreaktion wird häufig durch Mikroorganismen wie Pseudomonas aeruginosa oder Haemophilus influenzae getriggert. Chronischer Husten mit putridem Auswurf und zeitweisen Hämoptysen sind typische klinische Beschwerden. Zur Diagnostik ist die hochauflösende CT die Methode der Wahl. Bei der Therapie steht die Behandlung der Grunderkrankung im Vordergrund. Atem- und physiotherapeutische Maßnahmen stellen nach wie vor die Basis der Therapie dar. Bei akuter Verschlechterung/Exazerbation sollte im besten Falle eine kalkulierte Antibiotikatherapie nach Antibiogramm erfolgen. Eine Erregerdiagnostik sollte vorweg erfolgen. Bei unbekanntem Erreger sollte eine empirische Therapie eingeleitet werden, die auch Pseudomonas erfasst.

Abstract

Bronchiectasis has become less common because of the development of antibiotic therapy and vaccination. Bronchiectasis is mostly found in subsegmental bronchi and the chronic inflammation is frequently triggered by Pseudomonas aeruginosa and Haemophilus influenzae infections. Typical symptoms of this disease are a chronic cough with suppurant sputum and intermittent haemoptysis. Computed tomography scanning of the lungs is the diagnostic instrument of choice. Besides antibiotic treatment of exacerbations, physiotherapeutical measures are also important. In cases of exacerbation microbiological investigations of respiratory samples should be obtained before administration of antibiotics in order to identify antibiotic resistance. Pseudomonas aeruginosa is a frequent pathogen in bronchiectasis and therefore empiric treatment of exacerbations should always contain agents with anti-pseudomonal activity.

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Authors and Affiliations

  1. Abteilung Pneumologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover

    T. Fuehner, M. W. Pletz & T. Welte

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  1. T. Fuehner
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  2. M. W. Pletz
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  3. T. Welte
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Correspondence to T. Fuehner.

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Fuehner, T., Pletz, M.W. & Welte, T. Bronchiektasen. Pneumologe 3, 487–496 (2006). https://doi.org/10.1007/s10405-006-0124-x

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  • DOI: https://doi.org/10.1007/s10405-006-0124-x

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