Which physical examination findings are typically present in pneumonia?

• A. Wheezes only
• B. Clear lungs on auscultation
• C. Dullness to percussion only
• D. Fine or coarse crackles, bronchial breath sounds, egophony, and increased fremitus

Answer: (D)

Pneumonia causes alveolar spaces to fill with inflammatory fluid, leading to consolidation that changes how the lungs sound and transmit vibration. This makes a classic pattern on examination: fine or coarse crackles from the air moving through the inflamed, fluid-filled airways; bronchial breath sounds where the dense, consolidated tissue conducts sound more like the trachea than the distant airways; egophony, where spoken voice sounds change to an “E” that sounds like an “A” over the affected area; and increased fremitus because the solidified tissue conducts vibrations better than normal air-filled lungs. Percussion over the consolidated area tends to be dull. These combined findings reflect the presence of organized, airless tissue rather than normal aeration. In contrast, finding wheezes only, or clear lungs on auscultation, or dullness to percussion alone without the other changes, would not typically indicate pneumonia.