The main clinical manifestation of patients with bronchiectasis is a chronic cough with sputum production, although patients may only have a dry cough. Patients often have dyspnea on exertion (75%), wheezing (75%) and pleuritic chest pain (50%). Additionally, patients may have systemic symptoms, such as fatigue or weight loss, and rhinosinusitis. A physical examination may identify crackles (70%), snoring (44%) and wheezing (34%). Clubbing appears in approximately 3% of the cases. The clinical evolution consists of a progressive functional loss and is marked by recurrent infectious exacerbations with the need for frequent antibiotics