An exacerbation (sometimes called a flare-up) is a worsening of your usual symptoms. During an exacerbation, you may notice a worsening cough, increased mucus, changes in sputum color or thickness, greater shortness of breath, increased fatigue, coughing up blood, a fever or night sweats.

Exacerbations are sometimes described as sentinel events in BE: tipping points of worsening inflammation, usually triggered by infection, that result in significantly worse symptoms, and can cause additional airway damage and accelerate disease progression.

Patients who frequently exacerbate may represent a more severe phenotype of bronchiectasis, and this pattern can help guide treatment decisions, including consideration of anti-inflammatory therapies.

Exacerbations can be triggered by bacterial or viral infections, or inflammation and irritation from inhaled particles such as pollen or pollution.

People who experience frequent exacerbations – more than two or three per year – are at higher risk of hospitalization, more severe infections, and the need for IV antibiotics.

If your exacerbation symptoms last for more than 48 hours, contact your healthcare provider. Your care team will work to determine the cause of your exacerbation and recommend the best treatment, which may include antibiotics, airway clearance, or other supportive care. It may be necessary to drop off a sample of your sputum for culture.

Regular daily management, such as airway clearance and consistent use of prescribed medications, plays an important role in reducing the frequency and severity of exacerbations.