The aim of this study was to determine whether presence of viral symptoms influenced severity or outcome of exacerbations of bronchiectasis.Methods
Patients presenting to our outpatient service with exacerbations of bronchiectasis (defined as increasing cough, increasing sputum volume and worsening sputum purulence) requiring 2 weeks' oral antibiotic therapy were included. Patients reporting viral symptoms (defined as fever and any two of: unusual tiredness, headache, rhinorrhoea, sore throat, anorexia, myalgia, diarrhoea or vomiting) were compared with those who did not. The following outcomes were used to assess the exacerbation and response to 2 weeks' antibiotic therapy between the two groups: sputum bacteriology; sputum colour; 24 h sputum volume; respiratory viral PCR [Influenza A and B; Respiratory Syncytial Virus; Parainfluenza Type 1, 2, 3; Adenovirus]; incremental shuttle walk test; total white cell count; lymphocyte count; neutrophil count; C reactive protein; Erythrocyte Sedimentation Rate. Data is presented as median (IQR) and groups compared using the Mann–Whitney U Test.Results
40 patients were included. 17 reported viral symptoms. Of the 17 patients who reported viral symptoms, only 2 had positive viral PCR [Influenza Type B (n=1) and Respiratory Syncytial Virus (n=1)]. No patient in the group not reporting viral symptoms had a positive viral PCR. At the start of the exacerbation, there was no significant difference in any parameter between the groups and both groups had a similar and positive impact with 2-week course of antibiotic therapy. Abstract S107 table 1 details the measurements at the start and end of the exacerbation for each group.Conclusion
There was a low prevalence of positive virology despite the presence of viral symptoms and outcomes were similar in patients with and without viral symptoms. Larger cohort studies are needed.