Pneumonia differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2]

Pneumonia Microchapters
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Differentiating Pneumonia from other Diseases
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Overview

Pneumonia should be differentiated from other conditions that cause cough, fever, shortness of breath and tachypnea, such as asthma, COPD, CHF, cancer, GERD, pulmonary emboli.

Differentiating Pneumonia from other Diseases

Disease	Findings
Acute bronchitis	No infiltrates seen on the CXR.
Asthma	Past medical history, no infiltrates seen on chest X Ray.
Bronchiolitis obliterans	Should be suspected in patients with pneumonia who do not respond to antibiotics treatment.
Congestive heart failure	Bilateral pulmonary edema, shortness of breath.
COPD	Past medical history, no infiltrates on chest X Ray, fever is uncommon
Empyema	CXR showing features of pleural effusion, inflammatory markers on thoracocentesis.
Endocarditis	Finding of septic pulmonary emboli
Gastroesophageal reflux disease (GERD)	Normal chest X ray, symptoms worsening during night and associated with meals.
Lung abscess	CXR showing signs of lung abscess
Malignancy	Weight loss, clear sputum. CT scan and biopsy are helpful in ruling out malignancy.
Pertussis	Productive cough for weeks, nasopharyngeal aspirate aids in diagnosis.
Pulmonary embolus	A high degree of suspicion should be kept for pulmonary embolus. Chest X Ray may be normal.
Sinusitis	Sinus tenderness, post nasal drip.
Vasculitis	Systemic manifestations of collagen vascular disease may be seen.

References

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