What do tactile fremitus and dullness to percussion at the right lung base likely indicate in a person with CAP?

Tactile fremitus and dullness to percussion at the right lung base in a patient with community-acquired pneumonia (CAP) suggest the presence of lung consolidation.

When a healthcare provider assesses for tactile fremitus, they are feeling for vibrations transmitted through the lung tissue when a patient speaks. In cases of consolidation, such as pneumonia, the lung tissue becomes denser due to the accumulation of inflammatory exudates, fluid, or debris, leading to increased transmission of these vibrations. As a result, tactile fremitus is often more pronounced over areas of consolidation.

Dullness to percussion is another notable finding. Normally, percussion over the lungs produces a resonant sound due to the presence of air. However, when fluid or solid material accumulates in the lung (as seen in consolidation), the percussion note becomes dull. This is because denser materials do not transmit sound waves as well as air.

Together, these findings are classic indicators of consolidation within the lung, particularly in the presence of infection like pneumonia. Thus, the presence of increased tactile fremitus and dullness to percussion at the right lung base strongly points toward consolidation as the underlying pathology.