Sandbox: Bronchiolitis DD: Difference between revisions
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* Pulmonary function test is performed to exclude other lung diseases.<ref name="pmid18339530">{{cite journal| author=Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM et al.| title=An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients. | journal=Respir Med | year= 2008 | volume= 102 | issue= 6 | pages= 825-30 | pmid=18339530 | doi=10.1016/j.rmed.2008.01.016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18339530 }} </ref> | * Pulmonary function test is performed to exclude other lung diseases.<ref name="pmid18339530">{{cite journal| author=Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM et al.| title=An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients. | journal=Respir Med | year= 2008 | volume= 102 | issue= 6 | pages= 825-30 | pmid=18339530 | doi=10.1016/j.rmed.2008.01.016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18339530 }} </ref> | ||
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* Ct scan shows Intense bronchiolar mural inflammation of cellular bronchiolitis results in centrilobular | * Ct scan shows Intense bronchiolar mural inflammation of cellular bronchiolitis results in centrilobular nodules that are usually associated with the tree-in-bud pattern and bronchial wall thickening | ||
|- | |- | ||
|Asthma | |Asthma | ||
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* The presence of acid fast bacilli in sputum smear indicates to high extent tuberculosis. | * The presence of acid fast bacilli in sputum smear indicates to high extent tuberculosis. | ||
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* Chest X ray is an important diagnostic imaging procedure in TB diagnosis. It shows the following: | * Chest X ray is an important diagnostic imaging procedure in TB diagnosis. It shows the following:<ref>{{Cite journal | ||
| author = [[Riccardo Piccazzo]], [[Francesco Paparo]] & [[Giacomo Garlaschi]] | |||
| title = Diagnostic accuracy of chest radiography for the diagnosis of tuberculosis (TB) and its role in the detection of latent TB infection: a systematic review | |||
| journal = [[The Journal of rheumatology. Supplement]] | |||
| volume = 91 | |||
| pages = 32–40 | |||
| year = 2014 | |||
| month = May | |||
| doi = 10.3899/jrheum.140100 | |||
| pmid = 24788998 | |||
}}</ref> | |||
**Parenchymal infilration | **Parenchymal infilration | ||
**Hilar adnopathy | **Hilar adnopathy | ||
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|<nowiki>+</nowiki> | |<nowiki>+</nowiki> | ||
|Productive | |Productive | ||
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| - | |||
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* Arterial blood gases: hypoxemia and PaO2/FiO2 less than 200 mmHg which indicates acute respiratory distress syndrome. | |||
* Other lab tests are non specific and usually used to exclude other diseases. | |||
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* Chest X ray shows bilateral airway opacification. | |||
* CT scan shows ground glass appearance. | |||
* Bronchoscopy may be performed to exclude other causes like alveolar hemorrhage and lymphoma. | |||
* Lung biopsy is a last step in diagnosis of acute interstitial pnemonitis in order to confirm the disease and exclude other causes of ARDS. | |||
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|Foreign body aspiration | |Foreign body aspiration | ||
| + | |||
|Bloody | |||
|<nowiki>+</nowiki> | |||
| + | |||
| - | |||
| - | | - | ||
| - | | - | ||
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* Lab tests are not specific. They are performed to evaluate the ventilation function. | |||
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* Chest X ray shows hyperinflation, mediastinal shift and atelectasis. | |||
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|Pertussis | |Pertussis | ||
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|Dry | |Dry | ||
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| - | |||
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| - | | - | ||
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* Nasopharyngeal swab for PCR testing. | |||
* Sputum culture | |||
* Nasopharyngeal swab | |||
* | |||
* Serology to detect pertussis toxin.<ref name="CDC4">[http://www.cdc.gov/pertussis/clinical/diagnostic-testing/diagnosis-confirmation.html Pertussis (whooping coug). Diagnosis confirmation. CDC.gov. Accessed on June 22, 2017]</ref><ref name="CDC3">[http://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection.html Pertussis (whooping cough). Specimen collection. CDC.gov. Accessed on June 22, 2017] </ref> | * Serology to detect pertussis toxin.<ref name="CDC4">[http://www.cdc.gov/pertussis/clinical/diagnostic-testing/diagnosis-confirmation.html Pertussis (whooping coug). Diagnosis confirmation. CDC.gov. Accessed on June 22, 2017]</ref><ref name="CDC3">[http://www.cdc.gov/pertussis/clinical/diagnostic-testing/specimen-collection.html Pertussis (whooping cough). Specimen collection. CDC.gov. Accessed on June 22, 2017] </ref> | ||
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Latest revision as of 19:12, 22 June 2017
Bronchiolitis should be differentiated with other diseases that cause cough and dysnea.
Diseases | Symptoms | Signs | Diagosis | ||||||
---|---|---|---|---|---|---|---|---|---|
Fever | Cough | Chest pain | Wheezes | Crackles | Edema | Tachycardia | Lab tests | Imaging | |
Bronchiolitis | +/- | Dry | - | + | + | - | +/- |
|
|
Asthma | - | Dry/Productive | - | + | - | + Pulmonary edema | - |
|
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COPD | + | Productive | - | + | + | + | + |
|
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Bacterial pneumonia | + | Productive | + | + | + | - | +/- |
|
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Pulmonary embolism | +/- | Bloody | + | + | + | + | + |
|
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Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia[4] | - | Dry | - | + | - | - | - |
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Tuberculosis | + | Bloody | + | - | - | + | - |
|
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Interstitial pneumonitis (Hamman - Rich syndrome) | + | Productive | - | - | + | - | - |
|
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Foreign body aspiration | + | Bloody | + | + | - | - | - |
|
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Pertussis | + | Dry | - | - | - | - |
| ||
Congestive heart failure | - | Dry/Productive | + while walking | - | - | + | + |
|
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Differential diagnosis of bronchiolitis: Asthma, COPD, sarcoidosis, pneumonia, heart failure, DIPNECH, foreign body inhalation, pulmonary embolism and GERD (in case it is associated with asthma).
References
- ↑ Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM; et al. (2008). "An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients". Respir Med. 102 (6): 825–30. doi:10.1016/j.rmed.2008.01.016. PMID 18339530.
- ↑ Lazović B, Svenda MZ, Mazić S, Stajić Z, Delić M (2013). "Analysis of electrocardiogram in chronic obstructive pulmonary disease patients". Med Pregl. 66 (3–4): 126–9. PMID 23653989.
- ↑ Cvitanic O, Marino PL (1989). "Improved use of arterial blood gas analysis in suspected pulmonary embolism". Chest. 95 (1): 48–51. PMID 2491801. Retrieved 2012-04-30. Unknown parameter
|month=
ignored (help) - ↑ Nassar AA, Jaroszewski DE, Helmers RA, Colby TV, Patel BM, Mookadam F (2011). "Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia: a systematic overview". Am J Respir Crit Care Med. 184 (1): 8–16. doi:10.1164/rccm.201010-1685PP. PMID 21471097.
- ↑ Drobniewski F, Caws M, Gibson A, Young D (2003). "Modern laboratory diagnosis of tuberculosis". Lancet Infect Dis. 3 (3): 141–7. PMID 12614730.
- ↑ Riccardo Piccazzo, Francesco Paparo & Giacomo Garlaschi (2014). "Diagnostic accuracy of chest radiography for the diagnosis of tuberculosis (TB) and its role in the detection of latent TB infection: a systematic review". The Journal of rheumatology. Supplement. 91: 32–40. doi:10.3899/jrheum.140100. PMID 24788998. Unknown parameter
|month=
ignored (help) - ↑ Jeong Min Ko, Hyun Jin Park & Chi Hong Kim (2014). "Pulmonary Changes of Pleural Tuberculosis: Up-to-Date CT Imaging". Chest. doi:10.1378/chest.14-0196. PMID 25086249. Unknown parameter
|month=
ignored (help) - ↑ Pertussis (whooping coug). Diagnosis confirmation. CDC.gov. Accessed on June 22, 2017
- ↑ Pertussis (whooping cough). Specimen collection. CDC.gov. Accessed on June 22, 2017
- ↑ Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (2013). "2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J. Am. Coll. Cardiol. 62 (16): e147–239. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
- ↑ D'Aloia A, Vizzardi E, Metra M (2016). "Can Carbohydrate Antigen-125 Be a New Biomarker to Guide Heart Failure Treatment?: The CHANCE-HF Trial". JACC Heart Fail. 4 (11): 844–846. doi:10.1016/j.jchf.2016.09.001. PMID 27810078.
- ↑ Agha SA, Kalogeropoulos AP, Shih J, Georgiopoulou VV, Giamouzis G, Anarado P, Mangalat D, Hussain I, Book W, Laskar S, Smith AL, Martin R, Butler J (2009). "Echocardiography and risk prediction in advanced heart failure: incremental value over clinical markers". J. Card. Fail. 15 (7): 586–92. doi:10.1016/j.cardfail.2009.03.002. PMID 19700135.