exacerbation

An exacerbation, in medical use, is a worsening or flare-up of a disease or its symptoms that goes beyond normal day-to-day variation and typically requires an escalation of treatment or medical evaluation. Exacerbations can occur in a wide range of chronic conditions and may be triggered by infections, environmental factors, medication nonadherence, or other comorbidities. They can vary in severity from mild increases in symptom burden to life-threatening episodes.

Common examples include asthma and chronic obstructive pulmonary disease (COPD), where exacerbations involve increased shortness of breath, coughing, wheeze, and changes in sputum, sometimes with fever. Triggers often include viral infections, allergens, air pollution, and inadequate maintenance therapy. In multiple sclerosis, a relapse is an acute or subacute emergence or worsening of neurological symptoms lasting at least 24 hours, potentially following a period of stability. Rheumatoid arthritis and other inflammatory conditions can exhibit flares with intensified joint pain, stiffness, or systemic symptoms. Differentiating an exacerbation from side effects, infection, or comorbidity is a key aspect of assessment.

Management aims to identify and treat triggers, temporarily intensify therapy, and provide supportive care. Treatments may include medications (such as bronchodilators, corticosteroids, antibiotics when an infection is suspected), rapid reassessment, and sometimes hospitalization. Prevention focuses on adherence to maintenance therapy, vaccination, lifestyle modifications, and avoiding known triggers. The term “exacerbation” is used variably across diseases, with some conditions using “flare” or “relapse” as alternative terminology. Prognosis depends on the underlying condition and the rapidity of appropriate management.