Bronchiectasis Sicca : A Hidden Cause of Hemoptysis

ABSTRACT : Bronchiectasis is a permanent abnormal dilatation of bronchi & bronchioles. Bronchiectasis sicca or dry bronchiectasis is a very rare condition in which there are all the features of bronchiectasis except for the absence of copious amount of sputum which is usually a hall mark of bronchiectasis .The condition has been scarcely reported. CASE REPORT A 26 year old army man presented to our hospital with complaints of breathlessness mostly on exertion , dry cough and episodes of hemoptysis on playing bigul(which is trumpet kind of instrument requiring excessive blowing of air ) in military band and exertion for past 2 years. He was treated with antibiotics for six times over the previous months. A digital Cxr was labeled normal from outside but on careful observation bilateral lower lobe infiltration was observed then HRCT was advised while scan showed early bronchiectatic changes in both lungs, mostly cystic and varicose type . Pulmonary function testing demonstrated a decrease in lung capacity with mild airflow obstruction. Bronchiectasis was diagnosed, and the patient began on a treatment program that included a bronchodilator, chest physiotherapy, antibiotics, and modified exercise program with advice to avoid playing bigul. Over the next 3 months, his symptoms improved dramatically, he regained his energy and was able to resume his normal lifestyle that included normal training, while continuing with his pulmonary treatment program. The diagnosis of bronchiectasis sicca is frequently delayed for months or years, often with symptoms misdiagnosed as bronchitis, asthma, or recurrent pneumonia.