Mycoplasma pneumonia differential diagnosis: Difference between revisions

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{{CMG}}
{{CMG}}
==Overview==
==Overview==
''Mycoplasma'' pneumonia must be differentiated from other causes of [[pneumonia]], [[chest pain]], [[dyspnea]], and [[cough]], such as other infectious causes, [[aspiration pneumonia]], [[pneumonitis]], [[lung abscess]], [[empyema]], [[COPD|COPD exacerbation]], [[asthma]], [[interstitial lung disease]], cardiac diseases, and [[malignancy|malignancies]].
''Mycoplasma'' pneumonia must be differentiated from other causes of [[pneumonia]], [[chest pain]], and [[cough]], such as other infectious causes, [[aspiration pneumonia]], [[pneumonitis]], [[lung abscess]], [[empyema]], [[COPD|COPD exacerbation]], [[asthma]], [[interstitial lung disease]], cardiac diseases, and [[malignancy|malignancies]].
 
==Differential Diagnosis==
==Differential Diagnosis==
Differential diagnosis for ''Mycoplasma'' pneumonia includes the following:
Differential diagnosis for ''Mycoplasma'' pneumonia includes the following:
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*[[Leukemia]]
*[[Leukemia]]
*[[Sarcoidosis]]
*[[Sarcoidosis]]
Mycoplasma pneumonia must be differentiated from other diseases that cause [[atypical pneumonia]] such as [[Q fever]] and [[legionella]]
{| class="wikitable"
!Disease
!Prominent clinical features
!Lab findings
!Chest X-ray
|-
|Q fever
|
* Q fever is characterized by abrupt onset of [[fever]], [[myalgia]], [[headache]], and other constitutional symptoms.
* [[Cough]] is the most prominent respiratory symptom and it is usually dry.<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref>
* [[Cough]] is associated with [[dyspnea]] and [[pleuritic chest pain]].
|
* [[Antibody]] detection using [[Immunofluorescence|indirect immunofluorescence]] (IIF) is the preferred method for diagnosis.
* [[Polymerase chain reaction|PCR]] can be used if IIF is negative, or very early once disease is suspected.
* [[Coxiella burnetii|''C. burnetii'']] does not grow on ordinary blood cultures, but can be cultivated on special media such as embryonated eggs or cell culture.
* A two-to-three fold increase in [[Aspartate transaminase|AST]] and [[ALT]] is seen in most patients.
|
[[Image:Q fever.gif|center|300px|thumb|Q fever pneumonia - - Case courtesy of Royal Melbourne Hospital Respiratory, Radiopaedia.org, rID 21993 ]]
|-
|[[mycoplasma pneumonia|''Mycoplasma'' pneumonia]]
|
* [[mycoplasma pneumonia|''Mycoplasma'' pneumonia]] can be [[asymptomatic]].
* [[Headache]], [[Nausea and vomiting|nausea]], and [[malaise]] usually precede the onset of symptoms.<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref>
* [[Cough]] is intractable and nonproductive.
|
* Postitve [[Coombs test]]
* [[Leukocytosis]]
* [[Thrombocytosis]]
|
[[Image:Atypical-pneumonia-mycoplasma - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781.jpg|center|300px|thumb|Mycoplasma pneumonia - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781]]
|-
|[[Legionellosis]]
|
* [[Legionellosis]] is characterized by cough that is slightly productive.<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref>
* Constitutional symptoms such as [[chills]], [[myalgia]], and [[arthralgia]].
* Gastrointestinal symptoms such as [[diarrhea]], [[nausea]], and [[vomiting]].
|
* Labs are nonspecific for diagnosing [[legionellosis]]
* [[Renal dysfunction|Renal]] and [[hepatic dysfunction]]
* [[Thrombocytopenia]] and [[leukocytosis]]
* [[Hyponatremia]]
|
[[Image:Legionella-pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816.jpg|center|300px|thumb|Legionella pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816 ]]
|-
|[[Chlamydia pneumonia]]
|
* There are no specific clinical features of [[chlamydia pneumonia]].
* Symptoms appear gradually.
* [[Chlamydia infection]] is usually associated with [[upper respiratory tract]] symptoms ([[pharyngitis]], [[sinusitis]], etc).
* It might be associated with extrapulmonary maifestations such as [[meningitis]] and [[Guillain-Barre syndrome]].<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref>
|
* [[Chlamydia pneumonia]] is usually associated with normal [[WBC|WBC count.]]
* Diagnosed with the presence of [[Antibody|antichlamydial antibody]] (through [[complement fixation]] or direct immunofluoroscence) or direct antigen detection.
|
[[Image:Chlamydia-pneumonia - Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID 14567.jpg|center|300px|thumb|Chlamydia-pneumonia - Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID 14567]]
|}
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 15:26, 29 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Mycoplasma pneumonia must be differentiated from other causes of pneumonia, chest pain, and cough, such as other infectious causes, aspiration pneumonia, pneumonitis, lung abscess, empyema, COPD exacerbation, asthma, interstitial lung disease, cardiac diseases, and malignancies.

Differential Diagnosis

Differential diagnosis for Mycoplasma pneumonia includes the following:

Mycoplasma pneumonia must be differentiated from other diseases that cause atypical pneumonia such as Q fever and legionella

Disease Prominent clinical features Lab findings Chest X-ray
Q fever
  • Antibody detection using indirect immunofluorescence (IIF) is the preferred method for diagnosis.
  • PCR can be used if IIF is negative, or very early once disease is suspected.
  • C. burnetii does not grow on ordinary blood cultures, but can be cultivated on special media such as embryonated eggs or cell culture.
  • A two-to-three fold increase in AST and ALT is seen in most patients.
Q fever pneumonia - - Case courtesy of Royal Melbourne Hospital Respiratory, Radiopaedia.org, rID 21993
Mycoplasma pneumonia
Mycoplasma pneumonia - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781
Legionellosis
Legionella pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816
Chlamydia pneumonia
Chlamydia-pneumonia - Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID 14567

References

  1. ↑ 1.0 1.1 1.2 1.3 Irfan M, Farooqi J, Hasan R (2013). "Community-acquired pneumonia". Curr Opin Pulm Med. 19 (3): 198–208. doi:10.1097/MCP.0b013e32835f1d12. PMID 23422417.
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