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Causes of COPD Acute Exacerbations

WebMD Medical Reference from the COPD Foundation


Lung infections are the most common cause of acute exacerbations. These infections can be viral or bacterial. Some specific viruses that cause COPD exacerbations are influenza, rhinovirus or adenovirus. Recent evidence suggests exacerbations of COPD are often caused by certain kinds of bacteria. These are known as mycoplasma and chlamydia.

Your health care provider may need to consider the risk of you getting an infection from one of these less common organisms. He/she will need to consider this when prescribing an antibiotic for you. Other bacteria that commonly cause exacerbations are Streptococcus pneumoniae (Pneumococcus), Hemophilus influenzae, and Moraxella catarrhalis.

Bacteria and viruses can cause infections in various parts of the lung. An infection in the larger bronchial tubes can lead to bronchitis. An infection in the smallest bronchial tubes can cause bronchiolitis. And an infection in the air sacs and lung tissue can cause pneumonitis or pneumonia.

In COPD patients, an exacerbation is assumed to be caused by an infectious agent. This is unless there is another specific cause found. Antibiotics are only effective against bacterial infections. So they are not prescribed for suspected viral infections.

However, when COPD patients develop an acute exacerbation from a viral infection, they often get a secondary bacterial infection. This occurs because the build up of mucus and inflammation are a good breeding ground for bacterial infection. Therefore, antibiotic treatment is often the mainstay treatment for all acute exacerbations. This is true regardless of if bacteria has been found to be the cause.

Other common causes of acute exacerbations include:

  • Sinus infections
  • Indoor and outdoor air pollution
  • Heart failure (pulmonary edema)
  • Pulmonary embolism (blood clots to the lung)
  • Other disorders

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