Differential diagnosis project: Difference between revisions

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{{CMG}}
{{CMG}}
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{{ddx|Legionnaires' disease}}
{{ddx|Legionnaires' disease}}


=====History or clinical manifestations=====
=====Clinical manifestations=====
* Adult respiratory distress syndrome
* Bronchial breath sounds
* Dry cough
* High grade fever
* High grade fever
* Dry cough
* Progressive dyspnea
* Progressive dyspnea
* Bronchial breath sounds
* Adult respiratory distress syndrome


=====Laboratory or radiographic abnormalities=====
=====Laboratory abnormalities=====
* Legionella urinary antigen positive
* Legionella urinary antigen positive
=====Radiographic features=====
* Alveolar consolidation on chest radiograph
* Alveolar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
Line 37: Line 38:
{{ddx|Acute interstitial pneumonia}}
{{ddx|Acute interstitial pneumonia}}


=====History or clinical manifestations=====
=====Clinical manifestations=====
* Dry cough
* Dry cough
* Progressive dyspnea
* Progressive dyspnea
* Adult respiratory distress syndrome


=====Laboratory or radiographic abnormalities=====
=====Radiographic features=====
* Disseminated consolidation on chest radiograph
* Disseminated consolidation on chest radiograph
* Interstitial infiltrate on chest radiograph
* Interstitial infiltrate on chest radiograph
* Increased uptake on Gallium scan
* Increased uptake on gallium scan


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Line 51: Line 51:
{{ddx|Mycoplasma pneumonia}}
{{ddx|Mycoplasma pneumonia}}


=====History or clinical manifestations=====
=====Clinical manifestations=====
* Dry cough
* Dry cough
* Pleuritic chest pain
* Pleuritic chest pain
* Bronchial breath sounds
* Inflammed, opaque, hypomobile tympanic membrane
* Inflammed, opaque, hypomobile tympanic membrane
* Bronchial breath sounds


=====Laboratory or radiographic abnormalities=====
=====Laboratory abnormalities=====
* Lymphocytosis
* Lymphocytosis
* Cold agglutinins positive
* Cold agglutinins positive
=====Radiographic features=====
* Alveolar consolidation on chest radiograph
* Alveolar consolidation on chest radiograph
* Interstitial infiltrate on chest radiograph
* Interstitial infiltrate on chest radiograph
Line 68: Line 70:
{{ddx|Pneumococcal pneumonia}}
{{ddx|Pneumococcal pneumonia}}


=====History or clinical manifestations=====
=====Clinical manifestations=====
* High grade fever
 
* Hemoptysis
* Hemoptysis
* Fine rales
* Fine rales
Line 81: Line 85:
* Productive cough
* Productive cough
* Egophony
* Egophony
* High grade fever


=====Laboratory or radiographic abnormalities=====
=====Laboratory abnormalities=====
* Gram positive diplococci on sputum Gram stain
* Pleural effusion (exudative)
* Pleural effusion (exudative)
* Respiratory alkalosis  
* Respiratory alkalosis
 
=====Radiographic features=====
* Parenchymal hyperlucency on chest radiograph
* Parenchymal hyperlucency on chest radiograph
* Increased uptake on Gallium scan
* Increased uptake on gallium scan
* Unilateral diaphragm elevation on chest radiograph
* Unilateral diaphragm elevation on chest radiograph
* Alveolar consolidation on chest radiograph
* Alveolar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
* Gram positive diplococci on sputum Gram stain


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Line 97: Line 102:
{{ddx|Pneumocystis carinii pneumonia}}
{{ddx|Pneumocystis carinii pneumonia}}


=====History or clinical manifestations=====
=====Clinical manifestations=====
* Immunosuppressive state
* Immunosuppressive state
* Mediastinal emphysema
* Subcutaneous emphysema
* Subcutaneous emphysema
* Hacking cough
* Hacking cough
* Progressive dyspnea
* Progressive dyspnea


=====Laboratory or radiographic abnormalities=====
=====Laboratory abnormalities=====
* Respiratory alkalosis  
* Respiratory alkalosis
* Serum beta-D-glucan elevated
* Serum beta-D-glucan elevation
 
=====Radiographic features=====
* Alveolar consolidation on chest radiograph
* Alveolar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
* Interstitial infiltrate on chest radiograph
* Interstitial infiltrate on chest radiograph
* Pneumomediastinum on chest radiograph


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Line 115: Line 122:
{{ddx|Pulmonary embolism}}
{{ddx|Pulmonary embolism}}


=====History or clinical manifestations=====
=====Clinical manifestations=====
* Calf pain / swelling  
* Calf pain or swelling
* Decreased pulse pressure
* Decreased pulse pressure
* Dyspnea with normal chest X-ray
* Dyspnea
* Hemoptysis  
* Hemoptysis
* Hyperventilation  
* Hyperventilation
* Immobility  
* Immobility
* Increased pulmonic component of heart sound
* Increased pulmonic component of heart sound
* Pleuritic chest pain
* Pleuritic chest pain
* Prior DVT  
* Prior DVT
* Pulmonary hypertension  
* Pulmonary hypertension
* Right ventricular heave
* Right ventricular heave
* Right ventricular hypertrophy
* Right-to-left shunt
* Right-to-left shunt  
* Substernal chest pain
* Substernal chest pain  
* Tachypnea
* Tachypnea
* Thrombophlebitis  
* Thrombophlebitis
* Unilateral lower extremity edema
* Venous stasis
* Venous stasis
* Bone fracture


=====Laboratory or radiographic abnormalities=====
=====Laboratory abnormalities=====
* Atrial fibrillation
* D-dimer elevation
* Bone fracture
* Hypocapnia
* Hypoxia
* Pleural effusion (exudative or bloody)
* Atrial fibrillation on ECG
* Right axis deviation on ECG
* Right ventricular overload on ECG
 
=====Radiographic features=====
* Normal chest radiograph
* Atelectasis on chest radiograph
* Atelectasis on chest radiograph
* Lobar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
* Prominent pulmonary artery on chest radiograph
* Prominent pulmonary artery on chest radiograph
* Hampton's hump on chest radiograph
* Hampton's hump on chest radiograph
* D-dimer elevated
* Right ventricular enlargement on echocardiography
* Right ventricular enlargement on echocardiography
* Thrombus on echocardiography
* Thrombus on echocardiography
* Hypocapnia
* Hypoxia
* Segmental perfusion defect on lung scan
* Segmental perfusion defect on lung scan
* V/Q mismatch on lung scan
* V/Q mismatch on lung scan
* Pleural effusion (exudative / bloody)
* RVH on ECG
* Right axis deviation on ECG


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----
Line 157: Line 165:
{{ddx|Streptococcal pneumonia}}
{{ddx|Streptococcal pneumonia}}


=====History or clinical manifestations=====
=====Clinical manifestations=====
* Pectoriloquy  
* Pectoriloquy
* Bronchial breath sounds  
* Bronchial breath sounds
* Empyema
* Erythema nodosum
* Erythema nodosum  
* Purulent sputum
* Purulent sputum  
* Shallow respiration
* Shallow respiration  
* Increased tactile fremitus
* Increased tactile fremitus
* Pleuritic chest pain
* Pleuritic chest pain  
* Egophony
* Egophony  


=====Laboratory or radiographic abnormalities=====
=====Laboratory abnormalities=====
* Respiratory alkalosis
* Pleural effusion (exudative)
* Increased uptake on Gallium scan
* Gram-positive cocci in chains on sputum Gram stain
* Gram-positive cocci in chains on sputum Gram stain
* Respiratory alkalosis
* Pleural effusion (exudative)
=====Radiographic features=====
* Alveolar consolidation on chest radiograph
* Alveolar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
* Empyema on chest radiograph
* Increased uptake on gallium scan


----
----
Line 180: Line 190:
{{ddx|Viral pneumonia}}
{{ddx|Viral pneumonia}}


=====History or clinical manifestations=====
=====Clinical manifestations=====
* Pleuritic chest pain
* Pleuritic chest pain
* Bronchial breath sounds  
* Bronchial breath sounds
* Influenza
* Recent influenza
* Fine rales
* Fine rales
* Bronchovesicular breath sounds
* Bronchovesicular breath sounds


=====Laboratory or radiographic abnormalities=====
=====Laboratory abnormalities=====
* Lymphocytosis  
* Lymphocytosis
* Respiratory alkalosis  
* Respiratory alkalosis
 
=====Radiographic features=====
* Lobar consolidation on chest radiograph
* Lobar consolidation on chest radiograph
* Interstitial infiltrate on chest radiograph
* Interstitial infiltrate on chest radiograph

Revision as of 16:46, 9 August 2015

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

Instructions

Differential Diagnosis

The following conditions must be considered in the differential diagnosis of Legionnaires' disease: DDx [1][2][3][4][5][6][7]
  • Acute interstitial pneumonia DDx
  • Mycoplasma pneumonia DDx
  • Pneumococcal pneumonia DDx
  • Pneumocystis carinii pneumonia DDx
  • Pulmonary embolism DDx
  • Streptococcal pneumonia DDx
  • Viral pneumonia DDx


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Mahshid Mir, M.D. [3]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Adult respiratory distress syndrome
  • Bronchial breath sounds
  • Dry cough
  • High grade fever
  • Progressive dyspnea
Laboratory abnormalities
  • Legionella urinary antigen positive
Radiographic features
  • Alveolar consolidation on chest radiograph
  • Lobar consolidation on chest radiograph


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4] Mahshid Mir, M.D. [5]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Dry cough
  • Progressive dyspnea
Radiographic features
  • Disseminated consolidation on chest radiograph
  • Interstitial infiltrate on chest radiograph
  • Increased uptake on gallium scan


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [6] Mahshid Mir, M.D. [7]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Dry cough
  • Pleuritic chest pain
  • Bronchial breath sounds
  • Inflammed, opaque, hypomobile tympanic membrane
Laboratory abnormalities
  • Lymphocytosis
  • Cold agglutinins positive
Radiographic features
  • Alveolar consolidation on chest radiograph
  • Interstitial infiltrate on chest radiograph
  • Lobar consolidation on chest radiograph


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [8] Mahshid Mir, M.D. [9]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • High grade fever
  • Hemoptysis
  • Fine rales
  • Pleuritic chest pain
  • Increased breath sounds
  • Bronchial breath sounds
  • Dullness on chest percussion
  • Purulent sputum
  • Shallow respiration
  • Pectoriloquy
  • Increased tactile fremitus
  • Productive cough
  • Egophony
Laboratory abnormalities
  • Gram positive diplococci on sputum Gram stain
  • Pleural effusion (exudative)
  • Respiratory alkalosis
Radiographic features
  • Parenchymal hyperlucency on chest radiograph
  • Increased uptake on gallium scan
  • Unilateral diaphragm elevation on chest radiograph
  • Alveolar consolidation on chest radiograph
  • Lobar consolidation on chest radiograph


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [10] Mahshid Mir, M.D. [11]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Immunosuppressive state
  • Subcutaneous emphysema
  • Hacking cough
  • Progressive dyspnea
Laboratory abnormalities
  • Respiratory alkalosis
  • Serum beta-D-glucan elevation
Radiographic features
  • Alveolar consolidation on chest radiograph
  • Lobar consolidation on chest radiograph
  • Interstitial infiltrate on chest radiograph
  • Pneumomediastinum on chest radiograph


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [12] Mahshid Mir, M.D. [13]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Calf pain or swelling
  • Decreased pulse pressure
  • Dyspnea
  • Hemoptysis
  • Hyperventilation
  • Immobility
  • Increased pulmonic component of heart sound
  • Pleuritic chest pain
  • Prior DVT
  • Pulmonary hypertension
  • Right ventricular heave
  • Right-to-left shunt
  • Substernal chest pain
  • Tachypnea
  • Thrombophlebitis
  • Venous stasis
  • Bone fracture
Laboratory abnormalities
  • D-dimer elevation
  • Hypocapnia
  • Hypoxia
  • Pleural effusion (exudative or bloody)
  • Atrial fibrillation on ECG
  • Right axis deviation on ECG
  • Right ventricular overload on ECG
Radiographic features
  • Normal chest radiograph
  • Atelectasis on chest radiograph
  • Lobar consolidation on chest radiograph
  • Prominent pulmonary artery on chest radiograph
  • Hampton's hump on chest radiograph
  • Right ventricular enlargement on echocardiography
  • Thrombus on echocardiography
  • Segmental perfusion defect on lung scan
  • V/Q mismatch on lung scan


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [14] Mahshid Mir, M.D. [15]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Pectoriloquy
  • Bronchial breath sounds
  • Erythema nodosum
  • Purulent sputum
  • Shallow respiration
  • Increased tactile fremitus
  • Pleuritic chest pain
  • Egophony
Laboratory abnormalities
  • Gram-positive cocci in chains on sputum Gram stain
  • Respiratory alkalosis
  • Pleural effusion (exudative)
Radiographic features
  • Alveolar consolidation on chest radiograph
  • Lobar consolidation on chest radiograph
  • Empyema on chest radiograph
  • Increased uptake on gallium scan


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [16] Mahshid Mir, M.D. [17]

Differential Diagnosis
DDx Alphabetic Order
A B
C D
E F
G H
I J
K L
M N
O P
Q R
S T
U V
W X
Y Z


Template:WikiDoc Sources

Clinical manifestations
  • Pleuritic chest pain
  • Bronchial breath sounds
  • Recent influenza
  • Fine rales
  • Bronchovesicular breath sounds
Laboratory abnormalities
  • Lymphocytosis
  • Respiratory alkalosis
Radiographic features
  • Lobar consolidation on chest radiograph
  • Interstitial infiltrate on chest radiograph
  1. ↑ Ferri, Fred (2011). Ferri's differential diagnosis: a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323076999.
  2. ↑ Siegenthaler, Walter (2007). Differential diagnosis in internal medicine: from symptom to diagnosis. Stuttgart New York: Thieme. ISBN 978-1588905512.
  3. ↑ Mesko, Dusan (2002). Differential diagnosis by laboratory medicine: a quick reference for physicians. Berlin New York: Springer-Verlag. ISBN 978-3540430575.
  4. ↑ Reeder and Felson's gamuts in radiology: comprehensive lists of roentgen differential diagnosis. Place of publication not identified: Springer. 2014. ISBN 978-1475781229.
  5. ↑ Burgener, Francis (2008). Differential diagnosis in conventional radiology. Stuttgart New York: Thieme. ISBN 978-1588902757.
  6. ↑ Gattuso, Paolo (2015). Differential diagnosis in surgical pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1455770137.
  7. ↑ "DXplain".
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