Psittacosis differential diagnosis: Difference between revisions
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{{CMG}}; {{AE}} {{ADI}}{{DAMI}} | {{CMG}}; {{AE}} {{ADI}}{{DAMI}} | ||
==Overview== | ==Overview== | ||
Psittacosis must be differentiated from other diseases that cause [[atypical pneumonia]], febrile illness without localizing signs and extrapulmonary manifestations such as [[gastroenteritis]], [[hepatitis]], [[meningitis]], or [[encephalitis]]. The three main diseases to differentiate psittacosis from are [[Chlamydia pneumoniae]], [[Mycoplasma pneumoniae]], and [[Legionella infection]] as they tend to have similar clinical manifestations which can only be differentiated by taking appropriate histories and laboratory investigations. There are other conditions to watch out for which may also present similar to psittacosis. | Psittacosis must be differentiated from other diseases that cause [[atypical pneumonia]]<ref name="pmid3343952">{{cite journal| author=Yung AP, Grayson ML| title=Psittacosis--a review of 135 cases. | journal=Med J Aust | year= 1988 | volume= 148 | issue= 5 | pages= 228-33 | pmid=3343952 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3343952 }} </ref>, febrile illness without localizing signs and extrapulmonary manifestations such as [[gastroenteritis]], [[hepatitis]], [[meningitis]], or [[encephalitis]]. The three main diseases to differentiate psittacosis from are [[Chlamydia pneumoniae]], [[Mycoplasma pneumoniae]], and [[Legionella infection]] as they tend to have similar clinical manifestations which can only be differentiated by taking appropriate histories and laboratory investigations. There are other conditions to watch out for which may also present similar to psittacosis. | ||
==Differentiating Psittacosis from other Disease== | ==Differentiating Psittacosis from other Disease<ref name="pmid3343952">{{cite journal| author=Yung AP, Grayson ML| title=Psittacosis--a review of 135 cases. | journal=Med J Aust | year= 1988 | volume= 148 | issue= 5 | pages= 228-33 | pmid=3343952 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3343952 }} </ref>== | ||
Psittacosis can be differentiated in 3 categories based on the manifestations of the patient. For the patient with atypical pneumonia, other conditions to consider include; | Psittacosis can be differentiated in 3 categories based on the manifestations of the patient. For the patient with atypical pneumonia, other conditions to consider include; | ||
*[[Chlamydia pneumoniae|Chlamydia pneumoniae]] | *[[Chlamydia pneumoniae|Chlamydia pneumoniae]] | ||
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*[[Septicemia]] | *[[Septicemia]] | ||
*[[Vasculitis]] | *[[Vasculitis]] | ||
*[[Coxiella burnetii infection]] | *[[Coxiella burnetii infection]]<ref name="pmid7756465">{{cite journal| author=Raoult D, Marrie T| title=Q fever. | journal=Clin Infect Dis | year= 1995 | volume= 20 | issue= 3 | pages= 489-95; quiz 496 | pmid=7756465 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7756465 }} </ref> | ||
*[[Leptospirosis]] | *[[Leptospirosis]] | ||
*[[Brucellosis]] | *[[Brucellosis]] | ||
Revision as of 15:36, 10 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]Omodamola Aje B.Sc, M.D. [3]
Overview
Psittacosis must be differentiated from other diseases that cause atypical pneumonia[1], febrile illness without localizing signs and extrapulmonary manifestations such as gastroenteritis, hepatitis, meningitis, or encephalitis. The three main diseases to differentiate psittacosis from are Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella infection as they tend to have similar clinical manifestations which can only be differentiated by taking appropriate histories and laboratory investigations. There are other conditions to watch out for which may also present similar to psittacosis.
Differentiating Psittacosis from other Disease[1]
Psittacosis can be differentiated in 3 categories based on the manifestations of the patient. For the patient with atypical pneumonia, other conditions to consider include;
For the patient who presents with febrile illness without localizing signs, the following should also be considered;
- Influenza
- Endocarditis
- Septicemia
- Vasculitis
- Coxiella burnetii infection[2]
- Leptospirosis
- Brucellosis
Table 1; Differentiating C.psittaci from other diseases.
| Clinical feature | Cough | Sputum | Dyspnea | Sore throat | Headache | Confusion | Diarrhea | Chest radiograph changes | Hyponatremia | Leukopenia | Abnormal Liver function tests | Treatment |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C.psittaci | ++ | - | + | - | +++ | + | Minimal |
|
- | + | - | Doxycycline |
| C.pneumoniae | + | + | + | +++ | ++ | + | - |
|
- | - | - | Doxycycline, Azithromycin |
| M pneumoniae | ++ | ++ | ++ | - | - | - | - |
|
- | - | + | Doxycycline |
| L. Pneumophilla | + | +++ | +++ | - | + | ++ | + | Often Multifocal | ++ | + | ++ | Doxycycline |
| Influenza | ++ | ++ | ++ | ++ | ++ | +/- | +/- |
|
- | - | - | zanamivir, oseltamivir, |
| Endocarditis | ++ | ++ | + | - | - | - | - |
bases bilaterally |
- | +/- | +/- | Vancomycin |
| Coxiella burnetii infection | ++ | - | + | +/- | - | +/- | Minimal |
|
- | +/- | =/- | Doxyxycline |
| Leptospirosis | ++ | + | ++ | + | + | ++ | - |
|
+++ | Doxycycline, azithromycin, amoxicillin | ||
| Brucellosis | ++ | - | + | - | ++ | + | - |
|
-/+ | +/- | +/- | Doxycycline, rifampin |
Key;
+, occurs in some cases
++, occurs in many cases,
+++, occurs frequently