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An infectious exacerbation of COPD was defined when at least two of the following three criteria were fulfilled: (a) recent increase in dyspnea (b) increased sputum volume and (c) sputum purulence, provided that one of the two criteria is purulent sputum [ 16].
This study examined the accuracy of: (a) patient symptoms; (b) microscopic examination of sputum purulence (>25 WBCs and <10 epithelial cells) and (c) microscopic examination of morphological bacterial cell types, in identifying bacterial infection in patients with an acute exacerbation of chronic bronchitis (AECB) for entry to clinical trials.
Patients with increased sputum purulence are less likely than patients without increased sputum purulence to take action.
Recent work has shown correlation between sputum purulence and the presence of bacteria [ 15].
The symptoms are classified as major (breathlessness, sputum volume and sputum purulence) and minor (cough, wheeze, sore-throat and coryza).
Furthermore, 27% of exacerbating patients reported increased amounts of sputum and 28% reported a change in sputum purulence.
Similar(18)
Pulmonary criteria require at least two of a change in sputum (new purulence, change in character, increased secretions or increased suctioning requirement); new or worsening cough, dyspnea, or tachypnea; rales or bronchial breath sounds; and/or worsening gas exchange (oxygen desaturations, increased oxygen requirements, or increased ventilator demand).
Pneumonia was defined as the clinical diagnostic finding of a new and persistent infiltrate on chest x-ray, and a recent change in sputum or purulence in the sputum [ 9].
COPD patients frequently suffer acute exacerbations of the disease, characterised by an increase in dyspnoea, sputum volume or purulence.
Acute episodes of increased breathlessness, sputum production and/or purulence appearing during follow-up and treatment with antibiotics and/or oral corticosteroids by a physician were considered exacerbations [ 23].
Current treatment guidelines recommend antibiotic therapy for patients with a more severe illness [ 13– 15] and often use acute symptom changes based on Anthonisen criteria of type I (worsening dyspnoea with increased sputum volume and purulence) or II (change in any two of these symptoms) exacerbations to define this group.
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