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Infective COPD exacerbation — SCE Respiratory MCQ

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EasyCOPDInfective COPD exacerbationSCE Respiratory

A 59-year-old woman with COPD presents with increasing dyspnoea and sputum volume for 3 days. Sputum is now green, temperature is 37.8°C, CRP is 42 mg/L and CXR shows hyperinflation without consolidation. She has no penicillin allergy and no recent antibiotics. What is the most likely underlying cause?

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Correct answer: B — Bacterial infective COPD exacerbation

Purulent sputum with increased volume and dyspnoea in known COPD is most consistent with a bacterial infective exacerbation, even without lobar consolidation. Pulmonary oedema would usually have fluid overload signs or radiographic oedema, and pneumothorax would show pleural air. PAP and drug fibrosis do not fit the acute sputum-purulent presentation.

Reference: NICE NG115; NICE antimicrobial prescribing COPD exacerbation guidance