Pathophysiology of Bronchiolitis and Bronchiectasis.

EEK 5 DISCUSSION

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Both bronchiolitis and bronchiectasis present with a cough and dyspnea. Describe the pathophysiologic process of both bronchiolitis and bronchiectasis. Compare and contrast the two processes.

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Provide a clinical example of bronchiolitis and bronchiectasis.

Pathophysiology of Bronchiolitis and Bronchiectasis

Bronchiolitis has been found to be the result of inflammation within the lining of the epithelial cells in the small airways within the lungs resulting from direct viral inoculation. This inflammation causes the production of mucus, inflammation, and subsequent cellular necrosis of the affected cells (Verleden et al., 2016).Pathophysiology of Bronchiolitis and Bronchiectasis. It is inflammation of the cells mentioned above that causes obstruction in the airways and ultimately causes wheezing. It is important to note, however, that the mechanisms by which the respiratory syncytial virus spreads along the respiratory tract remains to be fully understood but is thought to be a function of either aspiration of nasopharyngeal secretions or cell-to-cell transferalong the intracytoplasmic bridges(Florin et al., 2017).Pathophysiology of Bronchiolitis and Bronchiectasis.

It is the host’s inflammatory response that contributes to the symptomatology and the pathophysiology of this disease. First, the host cells recognize the respiratory syncytial virus by means of toll-like receptors and respond through the secretion of inflammatory cytokines such as IL-4, IL-8, and IFN-γ.The above effectors directly influence tissue development and continue to enhance the inflammatory process by drawing immune cells from the periphery. The roles of many cytokines in the pathogenesis of RSV bronchiolitis are known, with some being thought to be responsible for the infection’s sustainment. An example of these cytokines is helper T cells cytokines known as IL-17 that enhance the RSV infection. This is achieved by inhibition of CD8 T cell activation, increasing mucus production, and reducing the rate of viral clearance(Florin et al., 2017).Pathophysiology of Bronchiolitis and Bronchiectasis.

On the other hand, Bronchiectasis is an abnormal dilation of the medium-sized and proximal bronchi that results from either destruction or weakening of the bronchial walls’ elastic and muscular components. This process starts with damage to the bronchial walls caused by an inflammatory response. This damage, in turn, stimulates the formation of thick mucus. The resulting moist and warn environment formed in the lungs combined with the excess mucus produces, thus causing further obstruction and inflammation, creating the optimum environment for infection (Chang et al., 2018). The thick mucus causes further damage by crushing the cilia. The immune response then releases inflammatory chemicals such as neutrophils that are toxic and also leads to bronchospasm and fibrosis if it persists. The affected areas show different changes such as edema, scarring, including transmural inflammation and ulceration. While Bronchiectasis is most often acquired, it may also be congenital (Bush and Floto 2019).Pathophysiology of Bronchiolitis and Bronchiectasis.

Clinical example of Bronchiolitis

A patient presents with coryzal symptoms and fever, followed by coughing and increased respiratory difficulty that shows tachypnoea. The patient also showed signs of chest hyperinflation. The patient complained of widespread fine crepitations and occasionally audible wheeze. The patient also complained of excessive sleepiness, poor feeding, irritability, vomiting, and diarrhea. Observation of the ear showed otitis media presence, while the throat showed the presence of pharyngitis.Pathophysiology of Bronchiolitis and Bronchiectasis.

Clinical example of Bronchiectasis

The clinical presentation of Bronchiectasis was different. The patient presented with a productive cough punctuated by episodes of pulmonary exacerbations where the color of sputum produced changes to green. The patient also reported occasionally coughing up blood (hemoptysis). They are reported fatigue, fever, and general malaise

Pathophysiology of Bronchiolitis and Bronchiectasis.