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Sputum induction can be used as a non-invasive technique to investigate airway inflammation in asthma and COPD. We reported the case of a 68 year old man with COPD, stage III GOLD, that underwent sputum induction during two exacerbation episodes. The first cell count showed a typical sputum neutrophilia, whereas the second showed sputum eosinophilia. On the basis of sputum cellularity, we decided to treat the first episode with a course of antibiotics and the second exacerbation with a course of antibiotics and oral steroids. The patient showed improvement in both cases, obtaining clinical stabilisation. The induced sputum cell count could be a useful technique in a clinical setting to evaluate the cellular characteristics of airway inflammation during COPD exacerbation and modulate the antinflammatory therapy.
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