Specialized consultative and continuity care for adults with bronchiectasis and chronic lung infections who do not have cystic fibrosis.
Bronchiectasis
Bronchiectasis is a common chronic lung condition characterized by abnormal enlargement of the bronchial tubes and a daily cough productive of sputum caused by chronic infection of the damaged bronchial tubes.
Mycobacterial Lung Disease
Mycobacteria are a family of bacteria that cause chronic infections of the lungs and sometimes other parts of the body. Tuberculosis is the best known Mycobacterium. However, in North America, most mycobacterial lung infections are caused by nontuberculous mycobacteria (NTM), notably Mycobacterium avium complex (MAC), also known as Mycobacterium avium intracellulare (MAI), and Mycobacterium abscessus.
Lung infections with these bacteria are increasing at an alarming rate in the United States, especially among otherwise healthy women 55 to 80 years of age, those with underlying lung disease, and those with an impaired immune system.
Other Chronic Lung Infections
Many bacteria other than NTM cause chronic lung infections in patients with bronchiectasis, notably bacteria such as Pseudomonas aeruginosa, Haemophilus influenza, and fungi like Aspergillus fumigatus.
The Need for Specialized Care
All these conditions require complex, interdisciplinary care for multiple reasons. Firstly, many patients have lung conditions which make them susceptible to chronic infections. Also, many of the infections are resistant to antibiotics (like Pseudomonas), while others require multiple antibiotics for an extended duration to be treated (like Mycobacteria). In addition, we tailor the patients’ medications to their needs and may include combinations of oral, nebulized, or intravenous routes. Patients also frequently need specialized techniques and devices to help clear infected secretions from their lungs. For these reasons, we feel a team approach provides the highest quality of care to the patient.
The Bronchiectasis, Mycobacterial Lung Disease, and Chronic Lung Infection Program
The Bronchiectasis, Mycobacterial Lung Disease, and Chronic Lung Infection Program at Penn is staffed by physicians, nurses, respiratory therapists, and pharmacists in pulmonary medicine and infectious disease who specialize in chronic lung infections. The team offers advanced diagnostic testing and advice on whether, when, and how best to treat these infections.
Our approach includes:
- An advanced diagnostic workup to determine whether an underlying immune or genetic disease explains why a person has one of these diseases.
- The ability to perform non-invasive sputum testing including induced sputum testing for those that cannot make enough mucus. If needed, we collaborate with interventional pulmonologists to help perform bronchoscopy to obtain lung samples.
- Oral, inhaled, and sometimes intravenous antibiotics in combinations that are customized to individual needs.
- Advanced, customized techniques for helping patients clear infected secretions from the lungs. The Harron Lung Center has a dedicated program with respiratory therapists to educate patients and facilitate their use of airway clearance techniques and equipment.
- Pulmonary rehabilitation to help patients regain function and quality of life.
- Lung surgery for some patients when antibiotic treatment is not enough
- Lung transplantation referral for select and complicated patients who can benefit from the procedure
- Participation in research. Our team performs clinical and translational research to better understand mycobacterial disease and participates in clinical trials to advance treatment options for patients suffering from NTM disease.