From the Guidelines
Lung sounds in pneumonia typically include crackles, bronchial breath sounds, and decreased breath sounds, as evidenced by the study by van Vugt 1, which found that the presence of crackles and diminished breath sounds at auscultation were key clinical prediction items for the diagnosis of pneumonia. The diagnosis of pneumonia is often confirmed by using chest radiographs, as noted in the study by Steurer et al, which was included in the chest guideline and expert panel report 1. Key clinical findings that suggest pneumonia include:
- Crackles (also called rales), which are discontinuous, brief popping sounds created when previously collapsed alveoli suddenly reopen during inspiration
- Bronchial breath sounds, characterized by a hollow, tubular quality, may also be present over consolidated lung tissue
- Decreased breath sounds in areas where air entry is significantly reduced due to consolidation
- Tachycardia (> 100 beats per minute) and fever (temperature ≥ 37.8C) are also important clinical findings, as noted in the study by van Vugt 1. The presence of these clinical findings, particularly crackles and diminished breath sounds, can help diagnose pneumonia, with a receiver operating characteristic (ROC) curve area of 0.70 (0.65-0.75) for the optimal combination of clinical prediction items, increasing to 0.77 (0.73-0.81) with the addition of CRP levels at the optimal cutoff > 30 mg/L 1.
From the Research
Lung Sounds in Pneumonia
- The provided studies do not directly address lung sounds in pneumonia, but rather focus on treatment outcomes and comparisons of different antibiotic regimens for community-acquired pneumonia (CAP) 2, 3, 4.
- One study mentions that there were no significant differences in respiratory sounds between treatment groups after receiving either oral Levofloxacin or a combination of parenteral Ceftriaxone and oral Azithromycin for CAP 3.
- The other studies do not mention lung sounds specifically, but discuss the efficacy and outcomes of various antibiotic treatments for CAP, including the use of azithromycin, ceftriaxone, clarithromycin, and levofloxacin 2, 4.
- Overall, there is limited information available in the provided studies regarding lung sounds in pneumonia, and further research would be needed to fully address this topic.