Aspiration pneumonia differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Aspiration_pneumonia]] | |||
{{CMG}}; {{AE}} {{KZ}}, {{Anmol}} | {{CMG}}; {{AE}} {{KZ}}, {{Anmol}} | ||
== | ==Aspiration pneumonia differential diagnosis== | ||
Aspiration pneumonia must be differentiated from other diseases that cause [[productive cough]], [[fever]], and [[dyspnea]]. | |||
{| | {| | ||
! | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Organ system | ||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases | ||
! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestations | ! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestations | ||
Line 27: | Line 28: | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |[[Respiratory system|'''Respiratory''']] | | align="center" style="background:#DCDCDC;" + rowspan="4" |[[Respiratory system|'''Respiratory''']] | ||
| align="center" style="background:#DCDCDC;" + |[[ | | align="center" style="background:#DCDCDC;" + |'''Foreing body [[Aspiration of foreign body|aspiration]]'''<ref name="pmid29221325">{{cite journal| author=Hewlett JC, Rickman OB, Lentz RJ, Prakash UB, Maldonado F| title=Foreign body aspiration in adult airways: therapeutic approach. | journal=J Thorac Dis | year= 2017 | volume= 9 | issue= 9 | pages= 3398-3409 | pmid=29221325 | doi=10.21037/jtd.2017.06.137 | pmc=5708401 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29221325 }}</ref><ref name="pmid11444115">{{cite journal |vauthors=Rafanan AL, Mehta AC |title=Adult airway foreign body removal. What's new? |journal=Clin. Chest Med. |volume=22 |issue=2 |pages=319–30 |year=2001 |pmid=11444115 |doi= |url=}}</ref><ref name="pmid26568942">{{cite journal| author=Haddadi S, Marzban S, Nemati S, Ranjbar Kiakelayeh S, Parvizi A, Heidarzadeh A| title=Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study. | journal=Iran J Otorhinolaryngol | year= 2015 | volume= 27 | issue= 82 | pages= 377-85 | pmid=26568942 | doi= | pmc=4639691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26568942 }}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Acute | |||
| align="center" style="background:#F5F5F5;" + | | |||
*Variable | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Wheeze|Wheezing]] | |||
*Decreased [[breath sounds]] | |||
| style="background:#F5F5F5;" + | | |||
*No specific tests | |||
| style="background:#F5F5F5;" + | | |||
*Hyperinflated lungs, [[atelectasis]], and [[mediastinitis]] | |||
*Shift in [[Chest X-ray|chest radiograph]] when the object is [[Radio-opaque|radio−opaque]] | |||
*[[Computed tomography|CT]] may be helpful | |||
| style="background:#F5F5F5;" + | | |||
*Not specific | |||
| style="background:#F5F5F5;" + | | |||
*[[Bronchoscopy]] | |||
| style="background:#F5F5F5;" + | | |||
*In children <1 year and adults >75 years | |||
*Organic materials in children | |||
*Inorganic materials in adults | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |[[Croup|'''Croup''']]<ref name="Cherry2008">{{cite journal|last1=Cherry|first1=James D.|title=Croup|journal=New England Journal of Medicine|volume=358|issue=4|year=2008|pages=384–391|issn=0028-4793|doi=10.1056/NEJMcp072022}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Acute | |||
| style="background:#F5F5F5;" + | | |||
*3−5 days | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Stridor]] | |||
*[[Rales|Crackles]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Leukopenia]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Respiratory system|Subglottic]] narrowing ([[steeple sign]]) in postero−anterior [[Radiography|radiograph]] chest | |||
| style="background:#F5F5F5;" + | | |||
*Decresed [[Lung volumes|tidal volume]] | |||
| style="background:#F5F5F5;" + | | |||
*Clinical diagnosis. | |||
*Laboratory findings and imaging are not necessary for diagnosis | |||
| style="background:#F5F5F5;" + | | |||
*[[Barking cough]] | |||
*Etiology: [[Human parainfluenza viruses|''Parainfluenza'' virus type 1]] (most common) | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |[[Pertussis|'''Pertussis''']]<ref name="pmid3816065">{{cite journal |vauthors=Bellamy EA, Johnston ID, Wilson AG |title=The chest radiograph in whooping cough |journal=Clin Radiol |volume=38 |issue=1 |pages=39–43 |year=1987 |pmid=3816065 |doi= |url=}}</ref><ref name="urlPertussis | Whooping Cough | Clinical | Information | CDC">{{cite web |url=https://www.cdc.gov/pertussis/clinical/index.html |title=Pertussis | Whooping Cough | Clinical | Information | CDC |format= |work= |accessdate=}}</ref> | | align="center" style="background:#DCDCDC;" + |[[Pertussis|'''Pertussis''']]<ref name="pmid3816065">{{cite journal |vauthors=Bellamy EA, Johnston ID, Wilson AG |title=The chest radiograph in whooping cough |journal=Clin Radiol |volume=38 |issue=1 |pages=39–43 |year=1987 |pmid=3816065 |doi= |url=}}</ref><ref name="urlPertussis | Whooping Cough | Clinical | Information | CDC">{{cite web |url=https://www.cdc.gov/pertussis/clinical/index.html |title=Pertussis | Whooping Cough | Clinical | Information | CDC |format= |work= |accessdate=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Acute | | align="center" style="background:#F5F5F5;" + |Acute | ||
Line 54: | Line 106: | ||
*Phases: Catarrhal, paroxysmal and convalescent | *Phases: Catarrhal, paroxysmal and convalescent | ||
|- | |- | ||
| | | align="center" style="background:#DCDCDC;" + |[[Rhinosinusitis|'''Rhinosinusitis''']]<ref name="pmid21490181">{{cite journal| author=Meltzer EO, Hamilos DL| title=Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines. | journal=Mayo Clin Proc | year= 2011 | volume= 86 | issue= 5 | pages= 427-43 | pmid=21490181 | doi=10.4065/mcp.2010.0392 | pmc=3084646 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21490181 }}</ref><ref name="pmid25832968">{{cite journal |vauthors=Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD |title=Clinical practice guideline (update): adult sinusitis |journal=Otolaryngol Head Neck Surg |volume=152 |issue=2 Suppl |pages=S1–S39 |year=2015 |pmid=25832968 |doi=10.1177/0194599815572097 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |[[Acute (medicine)|Acute]], [[subacute]], [[chronic]], recurrent | |||
| align="center" style="background:#F5F5F5;" + |Acute, | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Acute (medicine)|Acute]]: Less than 4 weeks | ||
*[[Subacute]]: 4−12 weeks | |||
*[[Chronic (medical)|Chronic]]: More than 12 weeks | |||
*Recurrent: 4 or more episodes or acute rhinosinusitis per year | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Clear chest | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *In complicated acute [[Rhinosinusitis|bacterial rhinosinusitis]], endoscopic cultures or [[sinus]] aspirate is indicated | ||
*Nasal culture may also be helpful | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Air−fluid level, mucosal [[edema]] and bony erosion of sinus on [[Computed tomography|CT]] | ||
*[[ | *[[Magnetic resonance imaging|MRI]] for distinguish the [[etiology]] | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Normal function | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Clinical diagnosis: [[Nasal congestion]], [[obstruction]], and purulent [[rhinorrhea]] | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Erythema]] in [[Periorbital edema|periorbital]] area | ||
|- | |- | ||
| align="center" style="background:# | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Organ system | ||
| align="center" style="background:#F5F5F5;" + | | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases | ||
! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestations | |||
! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diagnosis | |||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Other features | |||
|- | |||
! colspan="7" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Physical exam | |||
|- | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Onset | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Duration | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Productive cough | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hemoptysis | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Weight lost | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ascultation | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Lab findings | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Imaging | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |PFT | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | |||
|- | |||
| rowspan="4" align="center" style="background:#DCDCDC;" + |[[Respiratory system|'''Respiratory''']] | |||
| align="center" style="background:#DCDCDC;" + |'''[[Chronic obstructive pulmonary disease|Acute Bronchitis]]'''<ref name="pmid17108344">{{cite journal |vauthors=Wenzel RP, Fowler AA |title=Clinical practice. Acute bronchitis |journal=N. Engl. J. Med. |volume=355 |issue=20 |pages=2125–30 |year=2006 |pmid=17108344 |doi=10.1056/NEJMcp061493 |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Acute | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *From 5 days to 1 or 3 weeks | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | +/− | | align="center" style="background:#F5F5F5;" + | +/− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Wheezing]] | ||
| style="background:#F5F5F5;" + | | *[[Rhonchi]] | ||
*[[ | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Sputum culture]] is not indicated | ||
*[[Polymerase chain reaction|PCR]] in bacterial infection may be helpful | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Chest X-ray|Chest X−ray]] to exclude other diseases | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *FEV1 < 80% | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Clinical diagnosis | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Majority of cases are caused by [[respiratory]] [[viruses]] | ||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |''' | | align="center" style="background:#DCDCDC;" + |[[Chronic bronchitis|'''Chronic Bronchitis''']]<ref name="pmid24692133">{{cite journal |vauthors=Brusasco V, Martinez F |title=Chronic obstructive pulmonary disease |journal=Compr Physiol |volume=4 |issue=1 |pages=1–31 |year=2014 |pmid=24692133 |doi=10.1002/cphy.c110037 |url=}}</ref><ref name="pmid17975186">{{cite journal |vauthors=Qaseem A, Snow V, Shekelle P, Sherif K, Wilt TJ, Weinberger S, Owens DK |title=Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians |journal=Ann. Intern. Med. |volume=147 |issue=9 |pages=633–8 |year=2007 |pmid=17975186 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Chronic | | align="center" style="background:#F5F5F5;" + |Chronic | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Most of the days for three months in the las two years. | ||
| align="center" style="background:#F5F5F5;" + | + Clear [[sputum]] | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[Wheeze|Wheezing]] | *[[Wheeze|Wheezing]] | ||
*[[ | *[[Rhonchi]] | ||
| style="background:#F5F5F5;" + | | |||
| style="background:#F5F5F5;" + | | *[[CBC]] and [[ABG]] may be helpful | ||
*[[ | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Chest X-ray|Chest X−Ray]] to exclude other diseases | ||
*[[Computed tomography|CT]] | *[[Computed tomography|CT]] may also be helpful | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[FEV1/FVC ratio]] < 70% | ||
*[[ | *Post bronchodilatador [[FEV1]] > 80% | ||
*[[ | *Reduced [[Vital capacity|FVC]] after bronchodilatador administration | ||
* | *Decread [[vital capacity]] | ||
*Increased [[total lung capacity]] | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Demostration of airflow limitation on [[spirometry]] | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Smoker's cough]] | ||
*Cigarette smoking | |||
*Pollution | |||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |'''[[ | | align="center" style="background:#DCDCDC;" + |'''[[Emphysema]]''' <ref name="pmid28919728">{{cite journal| author=Rossi A, Butorac-Petanjek B, Chilosi M, Cosío BG, Flezar M, Koulouris N et al.| title=Chronic obstructive pulmonary disease with mild airflow limitation: current knowledge and proposal for future research - a consensus document from six scientific societies. | journal=Int J Chron Obstruct Pulmon Dis | year= 2017 | volume= 12 | issue= | pages= 2593-2610 | pmid=28919728 | doi=10.2147/COPD.S132236 | pmc=5587130 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28919728 }}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Chronic | | align="center" style="background:#F5F5F5;" + |Chronic | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Months to years | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + Mucoid or purulent [[sputum]] | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *Shortness of [[Breathing|breath]] | ||
*[[ | *[[Wheeze|Wheezing]] | ||
*[[ | *Prolonged [[Exhalation|expiration]] | ||
*[[Rales|Crackles]] | |||
*[[ | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Testing for [[Alpha 1-antitrypsin|alpha 1−antitrypsin]] may be helpful | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Chest X-ray|Chest X−Ray]] to exclude other diseases | ||
*[[Computed tomography|CT]] may also be helpful | |||
*[[Computed tomography|CT]] | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[FEV1/FVC ratio|FEV1/FVC]] <70% | ||
* | *Post [[bronchodilator]] [[FEV1]] >80 | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Detection of early [[emphysema]] in [[Computed tomography|CT]] of chest | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Exposure of tobacco and air pollution | ||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |[[ | | align="center" style="background:#DCDCDC;" + |[[Bronchiolitis|'''Bronchiolitis''']]<ref name="pmid14757603">{{cite journal |vauthors=Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L, Lohr KN |title=Diagnosis and testing in bronchiolitis: a systematic review |journal=Arch Pediatr Adolesc Med |volume=158 |issue=2 |pages=119–26 |year=2004 |pmid=14757603 |doi=10.1001/archpedi.158.2.119 |url=}}</ref><ref name="urlwww.nice.org.uk">{{cite web |url=https://www.nice.org.uk/guidance/ng9/resources/bronchiolitis-in-children-diagnosis-and-management-pdf-51048523717 |title=www.nice.org.uk |format= |work= |accessdate=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + |Acute | ||
| | | style="background:#F5F5F5;" + | | ||
* | *8−15 days | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Wheeze|Wheezing]] | ||
*[[ | *[[Rales|Crackles]] | ||
*[[ | *Increased [[respiratory rate]] | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Complete blood count]] ([[CBC]]) may be helpful | ||
*[[ | *[[Urinalysis]] & [[urine culture]] ( in infants) | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Chest X-Ray|Chest X−Ray]] may be helpful | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *Normal function or obstructive changes ([[FEV1/FVC ratio|FEV1/FVC]] <70%) | ||
*Air trapping in [[Lung volumes]] | |||
* | *Reduced [[DLCO|Diffusing capacity of carbon monoxide]] ( [[DLCO]]) | ||
* | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Clinical diagnosis | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Etiology: Respiratory ''[[Human respiratory syncytial virus|syncytial virus]], [[Rhinovirus]]'' | ||
*Children <2 years | |||
|- | |- | ||
! | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Organ system | ||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases | ||
! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestations | ! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestations | ||
Line 234: | Line 287: | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ||
|- | |- | ||
| | | rowspan="4" align="center" style="background:#DCDCDC;" + |[[Respiratory system|'''Respiratory''']] | ||
| align="center" style="background:#DCDCDC;" + |[[ | | align="center" style="background:#DCDCDC;" + |[[Pneumonia|'''Pneumonia''']]<ref name="pmid10987697">{{cite journal |vauthors=Bartlett JG, Dowell SF, Mandell LA, File Jr TM, Musher DM, Fine MJ |title=Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America |journal=Clin. Infect. Dis. |volume=31 |issue=2 |pages=347–82 |year=2000 |pmid=10987697 |doi=10.1086/313954 |url=}}</ref><ref name="pmid17278083">{{cite journal |vauthors=Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG |title=Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults |journal=Clin. Infect. Dis. |volume=44 Suppl 2 |issue= |pages=S27–72 |year=2007 |pmid=17278083 |doi=10.1086/511159 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Acute | | align="center" style="background:#F5F5F5;" + |Acute | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Variable | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + Mucopurulent [[sputum]] | ||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[Rales|Crackles]] | *[[Rales|Crackles]] | ||
* | *[[Egophony]] | ||
* | *Decreased bronchial sounds | ||
| style="background:#F5F5F5;" + | | |||
*Leftward shift [[leukocytosis]] | |||
| style="background:#F5F5F5;" + | | *[[Blood culture]] in hospitalized patients | ||
*[[ | *[[Sputum culture]] in hospitalized patients | ||
*[[Blood | |||
*[[ | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Consolidation (medicine)|Consolidation]], [[cavitation]], and infiltrated [[interstitial]] in [[Chest X-ray|chest X−ray]] | ||
*Anatomical changes observed in chest [[Computed tomography|CT]] | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*Not specific | *Not specific | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Infiltration observed in [[Chest X-ray|chest X−ray]] | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Community-acquired pneumonia|Community−acquired pneumonia]] | ||
* | *[[Healthcare-associated pneumonia|Healthcare−associated pneumonia]] | ||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |[[ | | align="center" style="background:#DCDCDC;" + |[[Lung cancer|'''Lung cancer''']]<ref name="pmid21296855">{{cite journal |vauthors=Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D |title=Global cancer statistics |journal=CA Cancer J Clin |volume=61 |issue=2 |pages=69–90 |year=2011 |pmid=21296855 |doi=10.3322/caac.20107 |url=}}</ref><ref name="pmid23649435">{{cite journal |vauthors=Ost DE, Jim Yeung SC, Tanoue LT, Gould MK |title=Clinical and organizational factors in the initial evaluation of patients with lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines |journal=Chest |volume=143 |issue=5 Suppl |pages=e121S–e141S |year=2013 |pmid=23649435 |pmc=4694609 |doi=10.1378/chest.12-2352 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Chronic | | align="center" style="background:#F5F5F5;" + |Chronic | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Years | ||
| align="center" style="background:#F5F5F5;" + | | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + | +/− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Hoarseness]] | ||
| style="background:#F5F5F5;" + |The following investigations may be helpful: | | style="background:#F5F5F5;" + |The following investigations may be helpful: | ||
*[[ | *[[Complete blood count]] ([[Complete blood count|CBC]]) | ||
*[[ | *[[Alanine transaminase|ALT]], [[Aspartate transaminase|AST]] | ||
*[[ | *[[Calcium]] | ||
*[[ | *[[Alkaline phosphatase]] | ||
*[[Lactate dehydrogenase|LDH]] | |||
*[[Creatinine]] | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Contrast enhanced CT|Contrast−enhanced CT]] of chest and upper abdomen | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Not specific | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Tissue [[biopsy]] (sample should be sufficient for [[Molecule|molecular]] testing) | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *Risk factor: | ||
**Cigarette smoking | |||
*[[ | *Types | ||
**[[Small cell lung cancer|Small cell lung cance]]<nowiki/>r ([[Small cell lung cancer|SCLC]]) | |||
**[[Non small cell lung cancer|Non−small cell lung cance]]<nowiki/>r ([[Non small cell lung cancer|NSCLC]]) | |||
|- | |- | ||
| | | align="center" style="background:#DCDCDC;" + |'''[[Tuberculosis]] ([[Tuberculosis|TB]])'''<ref name="pmid9332519">{{cite journal |vauthors=Perlman DC, el-Sadr WM, Nelson ET, Matts JP, Telzak EE, Salomon N, Chirgwin K, Hafner R |title=Variation of chest radiographic patterns in pulmonary tuberculosis by degree of human immunodeficiency virus-related immunosuppression. The Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA). The AIDS Clinical Trials Group (ACTG) |journal=Clin. Infect. Dis. |volume=25 |issue=2 |pages=242–6 |year=1997 |pmid=9332519 |doi= |url=}}</ref><ref name="pmid2456183">{{cite journal |vauthors=Barnes PF, Verdegem TD, Vachon LA, Leedom JM, Overturf GD |title=Chest roentgenogram in pulmonary tuberculosis. New data on an old test |journal=Chest |volume=94 |issue=2 |pages=316–20 |year=1988 |pmid=2456183 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Chronic | | align="center" style="background:#F5F5F5;" + |Chronic | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*More than 2 or 3 weeks | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Pleural effusion]] | |||
*[[Crackles]] | |||
*[[Whispered pectoriloquy]] | |||
*Decreased fremitus | |||
*[[Rhonchi]] | |||
| style="background:#F5F5F5;" + | | |||
*Sputum [[Acid-fast|acid−fast]] bacilli ([[Acid-fast|AFB]]) smear may be positive | |||
*[[Mycobacterium|Mycobacterial]] [[Culture media|culture]] may be positive | |||
*Molecular testing may be helpful | |||
| style="background:#F5F5F5;" + | | |||
*Reactivation of [[Tuberculosis|TB]] is observed as [[Infiltration (medical)|infiltration]] in the upper [[Lobe (anatomy)|lobe]] in [[Chest X-ray|chest X−Ray]] | |||
*In patients with [[Human Immunodeficiency Virus (HIV)|HIV]], Tb is observed as lobar [[Infiltration (medical)|infiltration]], [[adenopathy]], lung mass named [[tuberculoma]], small fibronodular lesions, and/or [[pleural effusion]] on [[Chest X-ray|chest X−Ray]] | |||
*[[Computed tomography|CT]] can detect early nodal process | |||
| style="background:#F5F5F5;" + | | |||
*Decreased [[FEV1]] | |||
*Reduced [[Vital capacity|FVC]] | |||
| style="background:#F5F5F5;" + | | |||
*Isolation of ''[[Mycobacterium tuberculosis]]'' from some [[secretion]] | |||
| style="background:#F5F5F5;" + | | |||
*Etiology: ''[[Mycobacterium tuberculosis]]'' | |||
*Complications: [[Pneumothorax]], [[bronchiectasis]], pulmonary destruction and [[chronic pulmonary aspergillosis]] | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |[[Cystic fibrosis|'''Cystic fibrosis''']] ([[Cystic fibrosis|CF]])<ref name="pmid18639722">{{cite journal |vauthors=Farrell PM, Rosenstein BJ, White TB, Accurso FJ, Castellani C, Cutting GR, Durie PR, Legrys VA, Massie J, Parad RB, Rock MJ, Campbell PW |title=Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report |journal=J. Pediatr. |volume=153 |issue=2 |pages=S4–S14 |year=2008 |pmid=18639722 |pmc=2810958 |doi=10.1016/j.jpeds.2008.05.005 |url=}}</ref><ref name="pmid1285737">{{cite journal |vauthors=Kerem E, Reisman J, Corey M, Canny GJ, Levison H |title=Prediction of mortality in patients with cystic fibrosis |journal=N. Engl. J. Med. |volume=326 |issue=18 |pages=1187–91 |year=1992 |pmid=1285737 |doi=10.1056/NEJM199204303261804 |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Chronic | |||
| align="center" style="background:#F5F5F5;" + | | |||
*Variable | *Variable | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + | +/− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *Barrel−shaped chest | ||
*[[ | *[[Wheezing]] | ||
*[[Tachypnea]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Respiratory tract]] [[Culture media|culture]] may be helpful for diagnosing secondary bacterial infection | |||
*[[Bronchoalveolar lavage]] for cytology may be helpful | |||
*≥ 60 mmol/L [[Sweat chloride test]] | |||
*[[CFTR (gene)|CFTR]] [[mutation]] in molecular testing may be positive | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Hyperinflation, [[atelectasis]], and infiltrates on [[Chest X-ray|chest X−Ray]] | ||
*Severe patients present bronchietasis, "tram tracks" [[Peribronchial cuffing|peribronchial cuffin]]<nowiki/>g in [[Chest X-ray|chest X−Ray]] | |||
*The extension of [[bronchietasis]] can be defined by [[Computed tomography|CT]] | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Residual volume|RV]]/[[Total lung capacity|TLC]] ratio increased | ||
*[[ | *[[FEV1/FVC ratio]] <70% | ||
*Low levels of [[FEV1]] | |||
*High levels of [[Total lung capacity|TLC]] | |||
*[[Residual volume|RV]] increased | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Sweat chloride test]] | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Evidence of [[Cystic fibrosis transmembrane conductance regulator|CFTR]] dysfunction | ||
| | |||
|- | |- | ||
! | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Organ system | ||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases | ||
! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestations | ! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestations | ||
Line 347: | Line 434: | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ||
|- | |- | ||
| | | rowspan="3" align="center" style="background:#DCDCDC;" + |'''[[Autoimmune]]''' | ||
| align="center" style="background:#DCDCDC;" + |[[Granulomatosis with polyangiitis|'''Wegener's disease''']] ([[Granulomatosis with polyangiitis|'''GPA''']]) <ref name="pmid1739240">{{cite journal |vauthors=Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS |title=Wegener granulomatosis: an analysis of 158 patients |journal=Ann. Intern. Med. |volume=116 |issue=6 |pages=488–98 |year=1992 |pmid=1739240 |doi= |url=}}</ref><ref name="pmid21374588">{{cite journal |vauthors=Falk RJ, Gross WL, Guillevin L, Hoffman GS, Jayne DR, Jennette JC, Kallenberg CG, Luqmani R, Mahr AD, Matteson EL, Merkel PA, Specks U, Watts RA |title=Granulomatosis with polyangiitis (Wegener's): an alternative name for Wegener's granulomatosis |journal=Arthritis Rheum. |volume=63 |issue=4 |pages=863–4 |year=2011 |pmid=21374588 |doi=10.1002/art.30286 |url=}}</ref> | | align="center" style="background:#DCDCDC;" + |[[Granulomatosis with polyangiitis|'''Wegener's disease''']] ([[Granulomatosis with polyangiitis|'''GPA''']]) <ref name="pmid1739240">{{cite journal |vauthors=Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS |title=Wegener granulomatosis: an analysis of 158 patients |journal=Ann. Intern. Med. |volume=116 |issue=6 |pages=488–98 |year=1992 |pmid=1739240 |doi= |url=}}</ref><ref name="pmid21374588">{{cite journal |vauthors=Falk RJ, Gross WL, Guillevin L, Hoffman GS, Jayne DR, Jennette JC, Kallenberg CG, Luqmani R, Mahr AD, Matteson EL, Merkel PA, Specks U, Watts RA |title=Granulomatosis with polyangiitis (Wegener's): an alternative name for Wegener's granulomatosis |journal=Arthritis Rheum. |volume=63 |issue=4 |pages=863–4 |year=2011 |pmid=21374588 |doi=10.1002/art.30286 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Chronic | | align="center" style="background:#F5F5F5;" + |Chronic | ||
Line 381: | Line 468: | ||
*[[Saddle nose|Saddle nose deformity]] | *[[Saddle nose|Saddle nose deformity]] | ||
*[[Purpura]] in lower extremities | *[[Purpura]] in lower extremities | ||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |'''Microscopic polyangitis ([[Microscopic polyangiitis|MPA]])'''<ref name="JennetteFalk1997">{{cite journal|last1=Jennette|first1=J. Charles|last2=Falk|first2=Ronald J.|title=Small-Vessel Vasculitis|journal=New England Journal of Medicine|volume=337|issue=21|year=1997|pages=1512–1523|issn=0028-4793|doi=10.1056/NEJM199711203372106}}</ref> | | align="center" style="background:#DCDCDC;" + |'''Microscopic polyangitis ([[Microscopic polyangiitis|MPA]])'''<ref name="JennetteFalk1997">{{cite journal|last1=Jennette|first1=J. Charles|last2=Falk|first2=Ronald J.|title=Small-Vessel Vasculitis|journal=New England Journal of Medicine|volume=337|issue=21|year=1997|pages=1512–1523|issn=0028-4793|doi=10.1056/NEJM199711203372106}}</ref> | ||
Line 486: | Line 537: | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
| |||
[[Category:Medicine]] | |||
[[Category:Pulmonology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Emergency medicine]] |
Latest revision as of 20:29, 29 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karina Zavaleta, MD [2], Anmol Pitliya, M.B.B.S. M.D.[3]
Aspiration pneumonia differential diagnosis
Aspiration pneumonia must be differentiated from other diseases that cause productive cough, fever, and dyspnea.
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical exam | |||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | |||
Respiratory | Foreing body aspiration[1][2][3] | Acute |
|
+ | + | − | + | + |
|
|
|
|
| |
Croup[4] | Acute |
|
+ | − | − | + | + |
|
|
|
| |||
Pertussis[5][6] | Acute |
|
+ Whooping sound | − | + | + | + |
|
|
|
|
|
| |
Rhinosinusitis[7][8] | Acute, subacute, chronic, recurrent | + | − | − | + | + |
|
|
|
|
| |||
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | ||||||||||
Symptoms | Physical exam | |||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | |||
Respiratory | Acute Bronchitis[9] | Acute |
|
+ | − | − | +/− | + |
|
|
|
|
| |
Chronic Bronchitis[10][11] | Chronic |
|
+ Clear sputum | − | − | + | + |
|
|
|
| |||
Emphysema [12] | Chronic |
|
+ Mucoid or purulent sputum | − | − | + | + |
|
|
|
|
| ||
Bronchiolitis[13][14] | Acute |
|
+ | − | − | + | + |
|
|
|
|
|
| |
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | ||||||||||
Symptoms | Physical exam | |||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | |||
Respiratory | Pneumonia[15][16] | Acute |
|
+ Mucopurulent sputum | − | − | + | + |
|
|
|
|
||
Lung cancer[17][18] | Chronic |
|
+ | + | + | +/− | + | The following investigations may be helpful: |
|
|
| |||
Tuberculosis (TB)[19][20] | Chronic |
|
+ | + | + | + | + |
|
|
|
|
| ||
Cystic fibrosis (CF)[21][22] | Chronic |
|
+ | − | + | +/− | + |
|
|
| ||||
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | ||||||||||
Symptoms | Physical exam | |||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | |||
Autoimmune | Wegener's disease (GPA) [23][24] | Chronic |
|
+ | + | + | + | + | The following investigations may be helpful: |
|
|
|
| |
Microscopic polyangitis (MPA)[25] | Chronic |
|
+ | + | + | + | + | The following investigations may be helpful:
|
|
|
|
| ||
Churg−Strauss[26][27] | Chronic |
|
+ | + | + | + | + |
|
|
|
|
References
- ↑ Hewlett JC, Rickman OB, Lentz RJ, Prakash UB, Maldonado F (2017). "Foreign body aspiration in adult airways: therapeutic approach". J Thorac Dis. 9 (9): 3398–3409. doi:10.21037/jtd.2017.06.137. PMC 5708401. PMID 29221325.
- ↑ Rafanan AL, Mehta AC (2001). "Adult airway foreign body removal. What's new?". Clin. Chest Med. 22 (2): 319–30. PMID 11444115.
- ↑ Haddadi S, Marzban S, Nemati S, Ranjbar Kiakelayeh S, Parvizi A, Heidarzadeh A (2015). "Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study". Iran J Otorhinolaryngol. 27 (82): 377–85. PMC 4639691. PMID 26568942.
- ↑ Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.
- ↑ Bellamy EA, Johnston ID, Wilson AG (1987). "The chest radiograph in whooping cough". Clin Radiol. 38 (1): 39–43. PMID 3816065.
- ↑ "Pertussis | Whooping Cough | Clinical | Information | CDC".
- ↑ Meltzer EO, Hamilos DL (2011). "Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines". Mayo Clin Proc. 86 (5): 427–43. doi:10.4065/mcp.2010.0392. PMC 3084646. PMID 21490181.
- ↑ Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD (2015). "Clinical practice guideline (update): adult sinusitis". Otolaryngol Head Neck Surg. 152 (2 Suppl): S1–S39. doi:10.1177/0194599815572097. PMID 25832968.
- ↑ Wenzel RP, Fowler AA (2006). "Clinical practice. Acute bronchitis". N. Engl. J. Med. 355 (20): 2125–30. doi:10.1056/NEJMcp061493. PMID 17108344.
- ↑ Brusasco V, Martinez F (2014). "Chronic obstructive pulmonary disease". Compr Physiol. 4 (1): 1–31. doi:10.1002/cphy.c110037. PMID 24692133.
- ↑ Qaseem A, Snow V, Shekelle P, Sherif K, Wilt TJ, Weinberger S, Owens DK (2007). "Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians". Ann. Intern. Med. 147 (9): 633–8. PMID 17975186.
- ↑ Rossi A, Butorac-Petanjek B, Chilosi M, Cosío BG, Flezar M, Koulouris N; et al. (2017). "Chronic obstructive pulmonary disease with mild airflow limitation: current knowledge and proposal for future research - a consensus document from six scientific societies". Int J Chron Obstruct Pulmon Dis. 12: 2593–2610. doi:10.2147/COPD.S132236. PMC 5587130. PMID 28919728.
- ↑ Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L, Lohr KN (2004). "Diagnosis and testing in bronchiolitis: a systematic review". Arch Pediatr Adolesc Med. 158 (2): 119–26. doi:10.1001/archpedi.158.2.119. PMID 14757603.
- ↑ "www.nice.org.uk".
- ↑ Bartlett JG, Dowell SF, Mandell LA, File Jr TM, Musher DM, Fine MJ (2000). "Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America". Clin. Infect. Dis. 31 (2): 347–82. doi:10.1086/313954. PMID 10987697.
- ↑ Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG (2007). "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults". Clin. Infect. Dis. 44 Suppl 2: S27–72. doi:10.1086/511159. PMID 17278083.
- ↑ Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011). "Global cancer statistics". CA Cancer J Clin. 61 (2): 69–90. doi:10.3322/caac.20107. PMID 21296855.
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