Last reviewed: March 2019
Last updated: April  2018

Summary

Definition

History and exam

Key diagnostic factors

  • dyspnea
  • cough
  • wheeze
  • changes in sputum volume/color/thickness
  • tachypnea
  • cyanosis
Full details

Other diagnostic factors

  • past medical hx COPD
  • tobacco use
  • past medical hx of gastroesophageal reflux/swallowing dysfunction
  • malaise and fatigue
  • chest tightness
  • features of cor pulmonale
  • environmental/occupational exposure to pollutants or dust
  • change in mental status
  • fever
  • accessory muscle use
  • paradoxical movements of abdomen
Full details

Risk factors

  • bacterial infection
  • gastroesophageal reflux/swallowing dysfunction
  • viral infection
  • atypical bacterial infection
  • pollutants
  • change in weather
Full details

Diagnostic investigations

1st investigations to order

  • SaO2 on pulse oximetry
  • chest radiograph
  • ECG
  • Arterial blood gas
  • CBC with platelets
  • electrolytes, BUN, + creatinine
Full details

Investigations to consider

  • sputum culture + Gram stain
  • respiratory virus diagnostics
  • cardiac troponin
  • CT scan of chest
Full details

Emerging tests

  • procalcitonin
Full details

Treatment algorithm

ACUTE

at presentation

ONGOING

after stabilization

Contributors

Authors VIEW ALL

Associate Professor

Yale University School of Medicine

New Haven

VA Connecticut Healthcare System

West Haven

CT

Disclosures

CLR serves on the COPD scientific advisory board for GlaxoSmithKline Pharmaceuticals but has no competing interests pertaining to this publication.

Associate Professor

Yale University School of Medicine

New Haven

Veterans Health Administration

Office of Public Health

West Haven

CT

Disclosures

RAM declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Medicine

Division Chief

Pulmonary/Critical Care/Sleep Medicine

University at Buffalo

State University of New York

Section Chief

Pulmonary/Critical Care/Sleep Medicine

VA Western New York Healthcare System

Buffalo

NY

Disclosures

SS declares that he has no competing interests.

Professor

Box Hill Hospital and Monash University

Victoria

Australia

Disclosures

FT declares that he has no competing interests.

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