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When emergency physicians evaluate patients who have chronic obstructive pulmonary disease and chronic sputum production, they frequently ask patients to characterize any change in sputum color, consistency, and volume. Changes in sputum may reflect increased obstruction, mucus plugging and retention, fluid retention, or bacterial or viral infection. Therapeutic options vary according to relative suspicions for these diverse etiologies. In a prospective study, these authors sought to determine whether sputum color is a reliable marker of bacterial infection in COPD exacerbations.
Of 121 patients with acute COPD exacerbations, 89 provided satisfactory sputum specimens. Positive bacterial cultures were obtained from 84 percent of green, purule…