From the Guidelines
Pneumonia is typically characterized by abnormal lung sounds, including crackles, bronchial breath sounds, and decreased breath sounds, which are crucial for prompt diagnosis and treatment. When examining a patient with suspected pneumonia, it is essential to listen for these abnormal sounds using a stethoscope. The most common abnormal lung sounds in pneumonia are:
- Crackles (or rales), which sound like small bubbles popping or cellophane being crumpled, usually heard during inspiration 1
- Bronchial breath sounds, which are louder and more tubular than normal vesicular breath sounds, heard over consolidated lung tissue 1
- Decreased breath sounds, which occur in areas where air entry is reduced due to inflammation and fluid accumulation 1 Additionally, wheezing might be present, especially in cases of bronchopneumonia, although it is not a reliable sign for determining severity in infants and young children 1. Pleural friction rubs, which sound like leather rubbing together, may also be heard if the pleura is inflamed. It is worth noting that the clinical diagnosis of pneumonia can be challenging, and the presence of these abnormal lung sounds, along with other clinical features such as fever, respiratory rate, and work of breathing, should be considered when making a diagnosis 1.
From the Research
Lung Sound in Pneumonia
- Lung sounds are an important diagnostic tool for pneumonia, but the provided studies do not directly address the topic of lung sounds in pneumonia 2, 3, 4, 5, 6.
- The studies focus on the treatment of community-acquired pneumonia (CAP) with different antibiotics, such as levofloxacin, azithromycin, and ceftriaxone, and their efficacy and tolerability 2, 3, 4.
- One study mentions that there was no significant difference in respiratory sounds between patients treated with levofloxacin and those treated with ceftriaxone plus azithromycin 4.
- Another study discusses the risk of subsequent isolation of multidrug-resistant organisms after treatment with moxifloxacin or ceftriaxone/azithromycin, but does not address lung sounds 5.
- A systematic review and meta-analysis of corticosteroids for adult patients hospitalized with non-viral community-acquired pneumonia found that corticosteroids probably reduced short-term mortality and the need for invasive mechanical ventilation, but does not mention lung sounds 6.
Treatment of Community-Acquired Pneumonia
- The studies suggest that levofloxacin monotherapy is as effective as combination therapy with azithromycin and ceftriaxone in treating CAP 2, 3, 4.
- The choice of antibiotic therapy may depend on various factors, including the severity of the disease, patient comorbidities, and the risk of multidrug-resistant organisms 2, 3, 4, 5.