China
Africa
Explore chapters and articles related to this topic
Diagnosis of COVID-19 Using Clinical Examination, Immunoassays, and Molecular Diagnostic Techniques
Published in Srijan Goswami, Chiranjeeb Dey, COVID-19 and SARS-CoV-2, 2022
Srijan Goswami, Ushmita Gupta Bakshi
Also, if indicated, some special tests like egophony or bronchophony may be performed. So, while auscultating the lungs, the presence of sounds like bronchial breath sounds, wheezing, crackles, rhonchi, egophony, or bronchophony might increase our suspicion of COVID-19 (Healthcare Workers, 2020a; World Health Organization: Geneva, 2020; Patient Assessment, 2020).
The respiratory system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
When there is a pleural effusion, the spoken voice heard through the stethoscope is high-pitched, with a nasal quality known as aegophony: this occurs because the improved transmission of high frequencies is accompanied by impaired transmission of the lower frequencies. (‘Aegophony’ means goat-voice, because of its bleating quality.)
Auscultation of Breath Sounds
Published in Noam Gavriely, David W. Cugell, Breath Sounds Methodology, 2019
Voice sounds are readily audible but not easily recognizable when heard on the chest wall with a stethoscope. In health, spoken words are muffled and obscure, with an upper frequency of approximately 250 Hz.106 Those lung diseases that cause a decrease in the amplitude of breath sounds or percussion note (pleural effusion or fibrosis, obstructed bronchus, obesity, solid tumors, etc.) result in a decrease in amplitude and additional muffling of vocal sounds. In a pneumothorax, vocal sounds are diminished although the percussion note is enhanced. Other lung diseases have the opposite effect, so that spoken sounds are loud and more easily recognizable (pneumonia, consolidation, atelectasis with a patent bronchus, etc.). The term bronchophony is used to describe vocal sounds with an abnormal increase in amplitude and in spoken clarity. When whispered voice sounds behave similarly it is known as pectoriloquy. A special form of bronchophony is egophony — a sound resembling the letter “a” when the patient utters the letter “e”. An increase in whispered voice sound is the most sensitive of vocal sound abnormalities, and as a sign of lung consolidation can often be appreciated prior to the appearance of abnormal breath sounds or adventitious sounds. There is increased transmission of higher-frequency sound through consolidated lung — up to approximately 400 Hz.106
Treatment of infections in cancer patients: an update from the neutropenia, infection and myelosuppression study group of the Multinational Association for Supportive Care in Cancer (MASCC)
Published in Expert Review of Clinical Pharmacology, 2021
Bernardo L. Rapoport, Tim Cooksley, Douglas B. Johnson, Ronald Anderson, Vickie R. Shannon
Common clinical features of CAP include fever, productive cough, dyspnea, tachypnea, and pleuritic chest pain. Leukocytosis, bronchial breath sounds, tactile fremitus, dullness to percussion, and egophony on lung examination are supportive findings; however, they are only present in approximately one-third of patients. Leukocytosis (typically between 15,000 and 30,000 per mm3) with a leftward shift is a common finding, particularly in pneumonia of bacterial origin. Leukopenia may also be seen and portends a poor prognosis. Mucopurulent sputum is a prominent feature of bacterial pneumonia, while symptoms of coryza, symptoms and myalgias more often signal pneumonia of viral origin [139]. Lung nodules or mass-like lesions with associated adenopathy, and abnormalities of the skin, central nervous system, or bone are important clues to fungal pneumonia. However, no clear constellation of signs and symptoms is reliably predictive of any specific type of pneumonia [39]. Furthermore, impaired immune responses in the cancer setting may diminish the clinical and radiographic hallmarks of pneumonia. Thus, fever, leukocytosis, and productive cough and the characteristic radiographic findings of lobar infiltrates may be minimal or absent. Competing diagnoses that mimic pneumonia, including diffuse alveolar hemorrhage, radiation pneumonitis, drug toxicity, hydrostatic pulmonary edema, and cancer progression, are frequent challenges for the neutropenic cancer patient and should be excluded with appropriate testing.
The calm before the storm: clinical observations of Middle East respiratory syndrome (MERS) patients
Published in Journal of Chemotherapy, 2018
Jaffar A. Al-Tawfiq, Kareem Hinedi
The second case is a 52-year-old Saudi gentleman with history of diabetes mellitus and dyslipidemia was admitted with cough, sputum production and fever. The patient has no nausea, vomiting or diarrhea. The patient had no animal contact and no raw camel milk ingestion. Vital signs were: temperature 38.5 °C, blood pressure 120/70 mm Hg and respiratory rate 18/min. Lungs examination revealed decreased air entry at the basis with evidence of consolidation in the left lower zone posteriorly with egophony. A nasopharyngeal swab was negative for MERS-CoV and influenza by PCR. Chest radiograph showed left lower lobe infiltrate. He was treated as a community acquired pneumonia and then oseltimavir was added. He continued to have fever of 38 °C and developed faint skin rash that was thought maybe secondary to medication versus viral exanthem. A repeat chest X-ray showed progression of consolidation in the right upper lobe. Five days after admission, his oxygen requirement started to increase. A sputum sample was positive for MERS-CoV by PCR. He continued to have intermittent pyrexia and his oxygen requirement increased to 6 L/min. He was started on interferon-α2b and Ribavirin. Repeat nasopharyngeal sample for MERS-CoV was negative, however, sputum return positive for MERS-CoV (Table 1). He required intensive care management and later he was discharged home.
Identifying the gap in clinical skills: a pilot study investigating the use of clinical respiratory examination skills in practice
Published in Education for Primary Care, 2021
Sophia Kerzner, Randi Q. Mao, Janhavi Nikhil Patel, Shreyas Sreeraman, Jason Profetto
Auscultating for breath sounds was the only skill in the entire survey to be unanimously useful. (100%). Additionally, almost all respondents (98.7%) felt that auscultating for breath sounds should be taught. The three auscultation techniques for consolidation (aegophony, whispered pectoriloquy, and bronchophony), were rated as useful by less than 20% of respondents. Most respondents felt that the consolidation tests should not be taught to students.