Coarse Crackles

MANUAL OF CLINICAL DIAGNOSIS

Coarse crackles are abnormal respiratory sounds auscultated during inspiration and sometimes during expiration. They are louder and lower-pitched than fine crackles and are usually associated with the presence of secretions or structural changes in the lungs. These sounds indicate that large and medium airways are obstructed by mucus, pus, or fluids and may be indicative of various chronic or acute pulmonary pathologies.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Bronchiectasis	Chronic productive cough, purulent sputum, haemoptysis, dyspnoea, scattered coarse crackles	Medical history of recurrent respiratory infections, physical examination	Chest X-ray, high-resolution computed tomography (HRCT)
Pulmonary Fibrosis	Progressive dyspnoea, dry cough, coarse crackles at lung bases, clubbing	Medical history, physical examination, basal crackles	Chest X-ray, HRCT, lung biopsy
Interstitial Lung Disease	Dyspnoea, dry cough, fatigue, scattered coarse crackles	Medical history, physical examination, coarse crackles at bases	Chest X-ray, HRCT, lung biopsy