Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chronic history of productive cough, recurrent sinopulmonary infections, and persistent nasal congestion. Clinical suspicion for Primary Ciliary Dyskinesia (PCD) is supported by a history of neonatal respiratory distress, chronic otitis media, and potential situs inversus (Kartagener syndrome). Review of systems positive for chronic rhinosinusitis, bronchiectasis, and subfertility.
Clinical Examination Findings
General: Patient appears in mild respiratory distress. HEENT: Chronic nasal polyposis, evidence of chronic otitis media or tympanostomy tubes. Chest: Auscultation reveals bilateral coarse crackles and wheezing, suggestive of bronchiectasis. Cardiovascular: Apex beat noted on the right side (dextrocardia). Abdomen: Potential situs inversus (liver dullness on the left).
Treatment Protocol
Management plan: 1. Airway clearance techniques (ACT) twice daily. 2. Hypertonic saline nebulization to improve mucociliary clearance. 3. Prophylactic antibiotics for recurrent exacerbations. 4. Referral to ENT for chronic sinusitis management. 5. Annual influenza and pneumococcal vaccinations. 6. Monitoring of pulmonary function tests (PFTs).