What is the cause of an expiratory wheezing (or rhonchi) sound on auscultation?

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Differential Diagnosis for Expiratory Rattling Sound on Auscultation

  • Single Most Likely Diagnosis
    • Chronic Obstructive Pulmonary Disease (COPD): This condition is characterized by chronic inflammation and airflow limitation in the lungs, often leading to expiratory wheezing or rattling sounds due to the obstruction of airways.
  • Other Likely Diagnoses
    • Asthma: Similar to COPD, asthma can cause expiratory wheezing or rattling sounds due to airway constriction and inflammation.
    • Bronchiectasis: A condition where the airways are permanently enlarged, leading to chronic cough, sputum production, and expiratory rattling sounds.
    • Pneumonia: Certain types of pneumonia, especially those caused by bacterial or viral infections, can lead to expiratory rattling sounds due to the presence of secretions and inflammation in the airways.
  • Do Not Miss Diagnoses
    • Pulmonary Embolism: Although less common, a pulmonary embolism can cause sudden onset of expiratory wheezing or rattling sounds, especially if it leads to pulmonary infarction or hemorrhage.
    • Foreign Body Aspiration: Aspiration of a foreign body can cause sudden onset of expiratory rattling sounds, especially in children or adults with altered mental status.
    • Epiglottitis: Inflammation of the epiglottis can cause stridor and expiratory rattling sounds, which can be life-threatening if not promptly treated.
  • Rare Diagnoses
    • Cystic Fibrosis: A genetic disorder that affects the respiratory, digestive, and reproductive systems, causing chronic respiratory infections and expiratory rattling sounds.
    • Alpha-1 Antitrypsin Deficiency: A rare genetic disorder that can cause COPD-like symptoms, including expiratory wheezing or rattling sounds, especially in non-smokers.
    • Tracheobronchomalacia: A rare condition characterized by weakness or floppiness of the airway walls, leading to expiratory rattling sounds or wheezing.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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