(Disclaimer: This article is for scientific use only, and relevant information in the following content has been processed to protect patient privacy.) Abstract: This case is a common bronchiectasis patient with recurrent cough and sputum for 15 years. This time, the patient was seen for an infection that persisted for more than 1 month and repeatedly used multiple anti-infective drugs with poor effect. Combining the history of coughing sputum and long anti-infective treatment, the anti-infective regimen was adjusted and sputum drainage was enhanced, and the infection was gradually controlled. This case shows that bronchiectasis is recurrent and anti-infective treatment is relatively special, and an anti-infective regimen that can cover Pseudomonas aeruginosa should be used for treatment. Basic information】Male, 45 years old 【Disease type】Bronchiectasis 【Visiting hospital】Pazhou People’s Hospital 【Visiting time】November 2021 【Treatment plan】Medication (ceftazidime, levofloxacin anti-infective treatment, auxiliary amiloride to dilute sputum) + auxiliary mechanical and manual sputum removal measures 【Treatment cycle】Hospitalization for 7 days 【Treatment effect】The condition was well controlled I. Initial interview When I first met Mr. Qi, I guessed that he was about 60 years old, with a waxy, old face. During the consultation, he repeatedly coughed and heard that there was a lot of sputum in his lungs, and it was very difficult to expel it, so it was obvious that the patient had been tortured by the disease for a long time and had serious consumption. The patient complained of recurrent cough and sputum for about 15 years, with a past history of smoking, 40 cigarettes per day, and a family history of lung cancer. 15 years ago, he was hospitalized in a local hospital for a lung infection, and his condition improved, but after that, he had a cold basically every month, and in severe cases, he developed bronchitis and pneumonia. After a lung CT several years ago, he found bronchial dilatation in his lungs. After that, he had a cough and sputum whenever he caught a cold, which became more frequent in cold weather, and his sputum was mostly purulent. Numerous chest films were taken repeatedly, often suggesting a lung infection. In the past month, he had a cough and sputum due to a cold. He took oral roxithromycin and amoxicillin by himself for 3 days with poor effect, and the infusion of cefradin, vincristine and azithromycin at the local hospital for 2 days was ineffective, and his sputum became especially sticky and yellowish-green, and there was a small amount of blood in his sputum in the morning. In order to improve his condition, he came to our hospital and was admitted as an outpatient with bronchiectasis and pulmonary nodules. After admission, routine blood tests and inflammatory indexes were mildly increased, while liver and kidney functions, electrocardiogram and cardiac ultrasound were not significantly abnormal. The lung examination showed that wet rales could be heard in the left lower lung, and the diagnosis of bronchiectasis combined with infection was clear. After hospitalization, the anti-infection treatment plan was adjusted, and ceftazidime and levofloxacin were given as anti-infection treatment, and amiloride was given to dilute sputum, and back patting and mechanically assisted sputum evacuation measures were given to the patient’s family to give hollow back patting and sputum evacuation after waking up every morning, and mechanical sputum evacuation machine was given once a day in the morning and once a day in the afternoon, and the chest wall was vibrated to evacuate sputum. In addition to this, the patient had a nodule in the lung with the possibility of tumor, and further improved further examinations such as tumor markers and enhanced CT. After the bronchial dilatation was controlled and stabilized, we strove to perform lung nodule aspiration biopsy as soon as possible, and further improved the diagnosis and treatment in thoracic surgery. III. Treatment effect After 6 days of drug anti-infection and mechanical and other adjuvant sputum removal treatment, the patient’s lung wet rales were significantly reduced on review, and the patient’s self-conscious cough and sputum symptoms were significantly improved, and his condition gradually improved. After one week of hospitalization, the patient was transferred to the Department of Thoracic Surgery to improve the further diagnosis and treatment of pulmonary nodules, as the patient was basically eligible for puncture in the case of pulmonary nodules. Since none of the anti-infective treatment measures given to the patient at the local hospital could effectively cover P. aeruginosa, the treatment was poor and the disease was prolonged. This shows that taking active and effective sputum-removal measures can help improve the efficacy of anti-infective treatment. IV. Precautions The patient’s condition is well controlled after a series of treatments, and we are happy for the patient. Patients also need to pay attention to the following matters: 1. If there is repeated aggravation of cough and sputum, seek medical consultation in time to remove the infection-causing bacteria to avoid delaying the condition and making it more and more serious; 2. Improve the immunity of the body to reduce the chance of respiratory tract infection; 3. For pulmonary nodular lesions, actively improve the diagnosis and treatment to avoid further development of the condition and delaying the treatment. 4, to protect the body, strengthen nutrition, add clothing in a timely manner, reduce upper respiratory infections, etc., and seek timely medical treatment for targeted treatment after the appearance of infection symptoms. V. Personal insight Bronchiectasis is a chronic infectious disease of the airways, of which bronchiectasis in adults, post-infection bronchiectasis is common. At the same time, patients with long-term recurrent respiratory infections, immunocompromised, combined with collapsed and dilated bronchial lumen are at high risk of combined Pseudomonas aeruginosa infection with yellow-green or yellow-purulent sputum. β-lactams with anti-Pseudomonas activity, such as piperacillin, aloxacillin, cefoperazone, ceftriaxone, ceftazidime, cefepime, meropenem or compound preparations containing enzyme inhibitors, combined with quinolones such as levofloxacin and ciprofloxacin, if necessary, are used in the anti-infective regimen selection. Due to the increase of drug resistance of Pseudomonas aeruginosa, it is better to choose more sensitive antibiotics according to the drug sensitivity test. The appropriate anti-infection program is to enhance sputum drainage and other measures based on the removal of the infected foci, which can significantly improve the symptoms.