Bronchiectasis laboratory findings: Difference between revisions
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*A gram stain and culture should be performed. Evidence of Psuedomonas species, Escherichia coli, or Staphylococcus. aureus may suggest cystic fibrosis or bronchopulmonary aspergillosis. | *A gram stain and culture should be performed. Evidence of Psuedomonas species, Escherichia coli, or Staphylococcus. aureus may suggest cystic fibrosis or bronchopulmonary aspergillosis. | ||
*A smear and culture should be performed for mycobacteria and fungi. | *A smear and culture should be performed for mycobacteria and fungi. | ||
*Sputum acid fast bacilli for Tuberculosis | |||
===Full Blood Count=== | ===Full Blood Count=== | ||
| Line 22: | Line 23: | ||
===Quantitative Immunoglobulin Levels=== | ===Quantitative Immunoglobulin Levels=== | ||
*Measure IgG, IgA, IgM, and serum electrophoresis to exclude hypogammaglobulinemia | *Measure IgG, IgA, IgM, and serum electrophoresis to exclude hypogammaglobulinemia | ||
*Serum IgE or skin prick testing for | *Serum IgE or skin prick testing or IgE radioallergosorbent test for ABPA | ||
:*Diagnostic criteria include a total serum IgE level greater than 1000 IU/mL or a greater than 2-fold rise from baseline. | |||
*Antibodies to Haemophilus influenza type B or Streptococcus pneumonia | |||
===Quantitative Serum Alpha 1-antitrypsin (AAT) Levels=== | |||
===Quantitative | |||
* This is used to rule out AAT deficiency. | * This is used to rule out AAT deficiency. | ||
== | ===Tests for Ciliary Function=== | ||
*Screening for PCD-nasal nitric oxide measurements, nasal biopsy and ciliary beat frequency | |||
*Screening should be done if there is childhood chronic otitis media, infertility, dextrocardia, or middle lobe bronchiectasis | |||
===Testing for Cystic Fibrosis=== | |||
*The testing is two measurements of sweat chloride and cystic fibrosis transmembrane regulator (CFTR) genetic mutation analysis should be done for all children and adults up to 40 years. | |||
*If the the patient is more than 40 years, he should do cystic fibrosis testing if he has persistent isolation of S. aureus in the sputum, features of malabsorption, male primary infertility, upper lobe bronchiectasis, or a history of childhood steatorrhoea. | |||
==References== | ==References== | ||
Revision as of 19:39, 24 June 2015
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Overview
There are both routine investigations and investigations done for special cases.
Bronchiectasis Laboratory Findings
Sputum Analysis
- Observe for Dittrich plugs (foul smelling masses of bacteria), white, or yellow concretions.
- A gram stain and culture should be performed. Evidence of Psuedomonas species, Escherichia coli, or Staphylococcus. aureus may suggest cystic fibrosis or bronchopulmonary aspergillosis.
- A smear and culture should be performed for mycobacteria and fungi.
- Sputum acid fast bacilli for Tuberculosis
Full Blood Count
- Nonspecific findings
- Anemia
- Elevated white blood cell count
- Increased percentage of neutrophils
- Eosinophils suggests bronchopulmonary aspergillosis.
- Polycythemia (secondary to hypoxia) in severe cases
Quantitative Immunoglobulin Levels
- Measure IgG, IgA, IgM, and serum electrophoresis to exclude hypogammaglobulinemia
- Serum IgE or skin prick testing or IgE radioallergosorbent test for ABPA
- Diagnostic criteria include a total serum IgE level greater than 1000 IU/mL or a greater than 2-fold rise from baseline.
- Antibodies to Haemophilus influenza type B or Streptococcus pneumonia
Quantitative Serum Alpha 1-antitrypsin (AAT) Levels
- This is used to rule out AAT deficiency.
Tests for Ciliary Function
- Screening for PCD-nasal nitric oxide measurements, nasal biopsy and ciliary beat frequency
- Screening should be done if there is childhood chronic otitis media, infertility, dextrocardia, or middle lobe bronchiectasis
Testing for Cystic Fibrosis
- The testing is two measurements of sweat chloride and cystic fibrosis transmembrane regulator (CFTR) genetic mutation analysis should be done for all children and adults up to 40 years.
- If the the patient is more than 40 years, he should do cystic fibrosis testing if he has persistent isolation of S. aureus in the sputum, features of malabsorption, male primary infertility, upper lobe bronchiectasis, or a history of childhood steatorrhoea.