Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic productive cough, exertional dyspnea, and recurrent sinopulmonary infections. History significant for chronic sinusitis. Symptoms characterized by mucopurulent sputum production and progressive decline in exercise tolerance. No history of smoking.
Clinical Examination Findings
Physical exam reveals bilateral coarse crackles and rhonchi on auscultation. Signs of chronic respiratory insufficiency may include digital clubbing or cyanosis. Sinus examination demonstrates tenderness or evidence of chronic rhinosinusitis.
Treatment Protocol
Initiate long-term, low-dose macrolide therapy (e.g., Erythromycin or Azithromycin) to modulate airway inflammation. Monitor pulmonary function tests (PFTs) and sputum cultures. Address comorbid chronic sinusitis with saline irrigation or topical steroids.