Symptoms
Since fremitus is a sign and not a disease, there are no symptoms of fremitus. However, the underlying condition causing the change in fremitus will have its own set of symptoms. For example, if increased fremitus is due to pneumonia, symptoms may include:
Cough (possibly with phlegm)
Fever
Shortness of breath
Chest pain
Fatigue If decreased fremitus is due to a pneumothorax, symptoms may include:
Sudden, sharp chest pain
Shortness of breath
Rapid heart rate
Causes
Fremitus changes are caused by alterations in the density of lung tissue or the presence of air or fluid in the pleural space. Common causes include:
Increased Fremitus: Pneumonia (consolidation), lung tumors
Decreased Fremitus: Pleural effusion, pneumothorax, emphysema, bronchial obstruction (e.g., tumor or mucus plug)
Medicine Used
The medications used depend entirely on the underlying cause of the altered fremitus. Some examples include:
Pneumonia: Antibiotics (e.g., amoxicillin, azithromycin, levofloxacin), bronchodilators (e.g., albuterol), cough suppressants, pain relievers.
Pleural Effusion: Diuretics (to reduce fluid buildup), antibiotics (if infection is present), pain relievers.
Pneumothorax: No medication is directly used, but pain medications may be provided. The primary treatment involves removing air from the pleural space via needle aspiration or chest tube insertion.
Is Communicable
? Whether the underlying condition is communicable depends on the cause.
Pneumonia: Some types of pneumonia (e.g., bacterial pneumonia, viral pneumonia) are communicable, while others (e.g., aspiration pneumonia) are not.
Pleural Effusion and Pneumothorax: Generally, these conditions themselves are not communicable unless caused by an infectious agent (like tuberculosis).
Precautions
Precautions depend on the underlying condition:
For communicable respiratory infections (like pneumonia):
Frequent handwashing
Covering coughs and sneezes
Staying home when sick
Vaccination (e.g., flu vaccine, pneumococcal vaccine)
General:
Avoiding smoking and exposure to secondhand smoke
Maintaining a healthy lifestyle to support immune function
How long does an outbreak last?
Again, this depends on the underlying cause. For example:
Pneumonia: A single episode of pneumonia typically lasts 1-3 weeks with appropriate treatment.
Pleural Effusion/Pneumothorax: Resolution depends on the underlying cause and treatment effectiveness. Recovery time can range from days to weeks or even longer in chronic cases.
How is it diagnosed?
Fremitus Assessment: Physical examination by a healthcare professional.
Underlying Condition Diagnosis:
Chest X-ray
CT scan of the chest
Sputum culture (if infection is suspected)
Blood tests (e.g., CBC, inflammatory markers)
Thoracentesis (for pleural effusion – fluid analysis)
Bronchoscopy (if airway obstruction is suspected)
Timeline of Symptoms
This varies greatly depending on the underlying condition. However, here are some general examples:
Pneumonia: Initial symptoms may include fever, cough, and fatigue, which worsen over a few days. Chest pain and shortness of breath may develop as the infection progresses. With treatment, symptoms typically start to improve within a few days.
Pneumothorax: Symptoms like sudden chest pain and shortness of breath appear abruptly.
Important Considerations
Fremitus is just one component of a respiratory examination. It should always be interpreted in conjunction with other findings (e.g., auscultation, percussion, patient history, imaging).
The absence of fremitus doesn't necessarily rule out disease. Subtle changes in fremitus can be difficult to detect, and other diagnostic tests are often needed.
Prompt evaluation and treatment are crucial for underlying conditions that cause changes in fremitus, especially those that can be life-threatening (e.g., tension pneumothorax, severe pneumonia).