Summary about Disease
Broncholithiasis refers to the presence of calcified or ossified material (broncholiths) within the bronchial lumen. These "lung stones" can cause airway obstruction, inflammation, and subsequent pulmonary complications. The broncholiths typically originate from calcified lymph nodes adjacent to the airways that erode into the bronchial tree.
Symptoms
Common symptoms include:
Chronic cough (often with expectoration of small, stone-like material)
Hemoptysis (coughing up blood)
Wheezing
Dyspnea (shortness of breath)
Recurrent pneumonia
Chest pain
Fever (if infection is present)
Causes
Granulomatous diseases: Histoplasmosis, tuberculosis, coccidioidomycosis, and other fungal infections are common causes, leading to calcified mediastinal or hilar lymph nodes that erode into bronchi.
Other causes: Foreign body aspiration, prior lung surgery, calcified bronchial cartilage, and rarely, migration of calcified rib cartilage.
Medicine Used
Treatment depends on the severity of symptoms and the size/location of the broncholith.
Bronchodilators: To open airways and ease breathing.
Corticosteroids: To reduce airway inflammation.
Antibiotics: To treat secondary infections like pneumonia.
Antitussives (cough suppressants): For symptomatic relief of cough (use cautiously, as it can hinder expectoration of the broncholith).
Mucolytics: To thin mucus and aid in expectoration.
Pain relievers: For chest pain. Note: Ultimately, the most effective "medicine" is often the removal of the broncholith itself (see "How is it diagnosed?").
Is Communicable
Broncholithiasis itself is not communicable. However, if the broncholithiasis is caused by an active infection (like tuberculosis), then *that infection* could be communicable. But the presence of the broncholith itself is not contagious.
Precautions
If the underlying cause is a communicable infection (like tuberculosis), standard precautions to prevent the spread of that infection should be followed.
Individuals with broncholithiasis should avoid irritants that could worsen respiratory symptoms, such as smoking, air pollution, and allergens.
Prompt medical attention should be sought for respiratory infections.
Adherence to prescribed medications is crucial.
How long does an outbreak last?
Broncholithiasis is not an "outbreak" disease. It's a chronic condition caused by the presence of the broncholith. The symptoms can persist until the broncholith is removed or treated, and can recur if there are further complications or underlying untreated disease. The duration of symptoms can vary greatly, from weeks to years, depending on the size, location, and complications associated with the broncholith.
How is it diagnosed?
Chest X-ray: May reveal calcified densities in the lung fields or hila.
Computed Tomography (CT) scan of the chest: The most sensitive imaging modality, allowing visualization of the broncholith and surrounding structures.
Bronchoscopy: Direct visualization of the airways, allowing for identification and sometimes removal of the broncholith. Bronchoscopy can also allow for biopsies or washings to be collected for further evaluation.
Sputum cultures: to rule out infection.
Timeline of Symptoms
The timeline of symptoms varies greatly:
Initial Stage: Mild, intermittent cough; may be dismissed as a minor respiratory irritation.
Progression: Cough becomes more persistent and productive; hemoptysis may develop. Wheezing and dyspnea can appear.
Complications: Recurrent pneumonia, bronchiectasis (permanent widening of airways), and other lung damage may develop over time.
Removal/Treatment: Symptoms may subside after broncholith removal or treatment of underlying infection. However, complications such as bronchiectasis may persist.
Important Considerations
Broncholithiasis can mimic other respiratory conditions, so a thorough evaluation is important for accurate diagnosis.
The underlying cause of the broncholithiasis should be identified and treated, if possible.
Surgical intervention may be necessary in cases where bronchoscopic removal is not feasible or in the presence of severe complications.
Long-term follow-up is often required to monitor for recurrence or complications.
Patient education is key to managing symptoms and preventing further lung damage.