Community-acquired pneumonia differential diagnosis: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
Line 3: Line 3:
{{CMG}}
{{CMG}}


==Differentiating Pneumonia From Other Diseases==
==Differentiating Pneumonia from other Diseases==
{| style="border: 0px; font-size: 90%; margin: 3px; width: 700px;" align=center
|valign=top|
|+'''Differential Diagnosis of Pneumonia''' <ref name="pmid1458569">{{cite journal| author=Schiele F, Muller J, Colinet E, Siest G, Arzoglou P, Brettschneider H et al.| title=Interlaboratory study of the IFCC method for alanine aminotransferase performed with use of a partly purified reference material. | journal=Clin Chem | year= 1992 | volume= 38 | issue= 12 | pages= 2365-71 | pmid=1458569 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1458569  }} </ref><ref name="pmid11113658">{{cite journal| author=Castro-Guardiola A, Armengou-Arxé A, Viejo-Rodríguez A, Peñarroja-Matutano G, Garcia-Bragado F| title=Differential diagnosis between community-acquired pneumonia and non-pneumonia diseases of the chest in the emergency ward. | journal=Eur J Intern Med | year= 2000 | volume= 11 | issue= 6 | pages= 334-339 | pmid=11113658 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11113658  }} </ref><ref name="Ahnsjö1935">{{cite journal|last1=Ahnsjö|first1=Sven|title=Contribution to the Differential Diagnosis of Pneumonia in Childhood|journal=Acta Paediatrica|volume=17|issue=3|year=1935|pages=439–446|issn=0803-5253|doi=10.1111/j.1651-2227.1935.tb07697.x}}</ref>


* [[Acute bronchitis]] - No infiltrates on the CXR.
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Disease}}
* [[Asthma]]- No infiltrates on the CXR.
! style="background: #4479BA; width: 500px;" | {{fontcolor|#FFF|Findings}}
* [[Bronchiolitis obliterans organizing pneumonia|Bronchiolitis obliterans with organizing pneumonia]] should be suspected in patients who fail to respond to antibiotics.
|-
* [[Congestive heart failure]] - Bilateral [[pulmonary edema]], involving more than the lower lung fields.
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Acute bronchitis]]
* [[Chronic obstructive pulmonary disease]] - No infiltrates on the CXR.
| style="padding: 5px 5px; background: #F5F5F5;" | No infiltrates seen on the CXR.
* [[Empyema]] - [[Pleural effusion]]s on the CXR; positive inflammatory markers on [[pleural fluid]] anaylsis.
|-
* [[Endocarditis]] with septic [[pulmonary emboli]]
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Asthma]]
* [[Gastroesophageal reflux disease]] - Normal CXR, symptoms worsen at night.
| style="padding: 5px 5px; background: #F5F5F5;" | Past medical history, no infiltrates seen on chest X Ray.
* [[Influenza]]
|-
* [[Lung abscess]] - CXR showing signs of [[lung abscess]].
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Bronchiolitis obliterans]]  
* [[Malignancy]] - CT scan and biopsy are helpful in ruling out malignancy.
| style="padding: 5px 5px; background: #F5F5F5;" | Should be suspected in patients with pneumonia who do not respond to antibiotics treatment.
* [[Pertussis]] - Productive cough for weeks, nasopharyngeal aspirate aids in diagnosis.
|-
* [[Pulmonary embolus]] - A high degree of suspicion should be kept for [[pulmonary embolus]]. CXR may be insiginificant.
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Congestive heart failure]]  
* [[Sinusitis]] - Sinus tenderness, [[post-nasal drip]].
| style="padding: 5px 5px; background: #F5F5F5;" | Bilateral [[pulmonary edema]], shortness of breath.
* [[Upper respiratory tract infection]]
|-
* [[Vasculitis]] - Systemic manifestations of [[collagen vascular disease]] may be seen.
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[COPD]]
| style="padding: 5px 5px; background: #F5F5F5;" | Past medical history, no infiltrates on chest X Ray, fever is uncommon
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Empyema]]
| style="padding: 5px 5px; background: #F5F5F5;" | CXR showing features of [[pleural effusion]], inflammatory markers on [[thoracocentesis]].  
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Endocarditis]]
| style="padding: 5px 5px; background: #F5F5F5;" | Finding of septic [[pulmonary emboli]]
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Gastroesophageal reflux disease]] (GERD)
| style="padding: 5px 5px; background: #F5F5F5;" | Normal chest X ray, symptoms worsening during night and associated with meals.
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Lung abscess]]  
| style="padding: 5px 5px; background: #F5F5F5;" | CXR showing signs of [[lung abscess]]
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Lung cancer]]  
| style="padding: 5px 5px; background: #F5F5F5;" | Weight loss, clear sputum.  CT scan and biopsy are helpful in ruling out malignancy.
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Pertussis]]
| style="padding: 5px 5px; background: #F5F5F5;" | Productive cough for weeks, nasopharyngeal aspirate aids in diagnosis.
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Pulmonary embolus]]
| style="padding: 5px 5px; background: #F5F5F5;" | A high degree of suspicion should be kept for [[pulmonary embolus]]. Chest X Ray may be normal.
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Sinusitis]]
| style="padding: 5px 5px; background: #F5F5F5;" | Sinus tenderness, post nasal drip.
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | [[Vasculitis]]
| style="padding: 5px 5px; background: #F5F5F5;" | Systemic manifestations of [[collagen vascular disease]] may be seen.
|}


==Differential Diagnosis of Community-Acquired Pneumonia Depending on Chest Radiograph==
==Differential Diagnosis of Community-Acquired Pneumonia Depending on Chest Radiograph==

Revision as of 18:34, 6 November 2014

Pneumonia Main Page

Community-Acquired Pneumonia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Community-acquired pneumonia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Severity Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

Ultrasound

Other Diagnostic Studies

Treatment

Hospital Admission Decision

Medical Therapy

Primary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Community-acquired pneumonia differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Community-acquired pneumonia differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Community-acquired pneumonia differential diagnosis

CDC on Community-acquired pneumonia differential diagnosis

Community-acquired pneumonia differential diagnosis in the news

Blogs on Community-acquired pneumonia differential diagnosis

Directions to Hospitals Treating Community-acquired pneumonia

Risk calculators and risk factors for Community-acquired pneumonia differential diagnosis

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

Differentiating Pneumonia from other Diseases

Differential Diagnosis of Pneumonia [1][2][3]
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
Lung cancer 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.

Differential Diagnosis of Community-Acquired Pneumonia Depending on Chest Radiograph
Normal chest X-ray Abormal chest X-ray
Adapted from N Engl J Med 2014; 370:543-551[4]

References

  1. ↑ Schiele F, Muller J, Colinet E, Siest G, Arzoglou P, Brettschneider H; et al. (1992). "Interlaboratory study of the IFCC method for alanine aminotransferase performed with use of a partly purified reference material". Clin Chem. 38 (12): 2365–71. PMID 1458569.
  2. ↑ Castro-Guardiola A, Armengou-Arxé A, Viejo-Rodríguez A, Peñarroja-Matutano G, Garcia-Bragado F (2000). "Differential diagnosis between community-acquired pneumonia and non-pneumonia diseases of the chest in the emergency ward". Eur J Intern Med. 11 (6): 334–339. PMID 11113658.
  3. ↑ Ahnsjö, Sven (1935). "Contribution to the Differential Diagnosis of Pneumonia in Childhood". Acta Paediatrica. 17 (3): 439–446. doi:10.1111/j.1651-2227.1935.tb07697.x. ISSN 0803-5253.
  4. ↑ Solomon, Caren G.; Wunderink, Richard G.; Waterer, Grant W. (2014). "Community-Acquired Pneumonia". New England Journal of Medicine. 370 (6): 543–551. doi:10.1056/NEJMcp1214869. ISSN 0028-4793.
Retrieved from "https://www.wikidoc.org/index.php?title=Community-acquired_pneumonia_differential_diagnosis&oldid=1039589"