The doctor, often a GP (general practitioner, primary care physician), will ask the patient about symptoms and carry out a physical examination when attempting to diagnose bronchiectasis (bronchiectasia). The GP will need to know details about the cough; how long it has been around and what it is like. If the cough occurs every day and produces large amounts of phlegm (sputum, spit) the doctor may suspect bronchiectasis.
When listening to the chest of a patient with bronchiectasis with a stethoscope, the physician may hear bubbling, clicking, wheezing, rattling, or other sounds - generally in the lower lobes of the lungs.
The GP may refer the patient to a specialist (pulmonologist).
Tests may be ordered to detect any possible underlying causes, rule out other illnesses and conditions which may have similar signs and symptoms, and to determine the extent of damage to the airways.
CT (computed tomography) scan of the chest - the CT scanner uses digital geometry processing to generate a 3-dimensional (3-D) image of the inside of an object. The 3-D image is made after many 2-dimensional (2-D) X-ray images are taken around a single axis of rotation - in other words, many pictures of the same area are taken from many angles and then placed together to produce a 3-D image. It is a painless procedure. A CT scan gives more detailed images than an X-ray.
CT findings of bronchiectasis and multiple small nodules are said to have a sensitivity of 80%, specificity of 87%, and accuracy of 80% for the detection of bronchiectasis.
- X-ray of the chest - this test may reveal abnormalities in the lungs and airways.
- Blood tests - can determine whether there is an infection. Blood tests can also help identify underlying conditions.
- Sputum culture - a sample of phlegm (sputum, spit) is collected and sent to the lab to determine whether there is an infection, and if so, what type (bacteria or fungi).
- PPD (purified protein derivative) skin test - to check for a prior tuberculosis infection. The test area, usually the forearm, is cleansed with rubbing alcohol. The PPD extract is injected under the top layer of skin, causing a welt to form (usually goes away within hours).
- Sweat test - consists of a small electrode placed on the skin that stimulates sweat glands to produce sweat. The sweat is then analyzed in a lab to test the amount of chloride (an ion found in salt). Chloride levels that are above a certain threshold indicate that the person has cystic fibrosis.
Lung function tests - these determine the extent of lung damage. They measure:
- The amount of air that is breathed in and out
- Breathing speed
- How effective the lungs deliver oxygen to the blood
- Bronchoscopy - a bronchoscope, a long, narrow, flexible tube with a light is inserted into the airways through either the nose or mouth, allowing the doctor to see the breathing passages via a video image. A bronchoscopy may be recommended if the patient does not respond to treatment. This procedure can detect any blockage or bleeding in the airways.