Psittacosis differential diagnosis: Difference between revisions

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'''Differentiating psittacosis from other diseases'''
'''Differentiating psittacosis from other diseases'''
{| class="wikitable"
{| class="wikitable"
!Clinical feature
! rowspan="2" |Disease
! colspan="7" |Clinical Manifestations
! colspan="3" |Lab findings
! rowspan="2" |Imaging findings
! rowspan="2" |Main treatment
|-
![[Cough]]
![[Cough]]
![[Sputum]]
![[Sputum]]
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![[Confusion]]
![[Confusion]]
![[Diarrhea]]
![[Diarrhea]]
!Chest radiograph changes
!Hyponatremia
!Hyponatremia
![[Leukopenia]]
![[Leukopenia]]
!Abnormal Liver function tests
!Abnormal Liver function tests
!Treatment
|-
|-
|Psittacosis
|Psittacosis
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| +
| +
|Minimal
|Minimal
|
* No changes seen
| -
| -
| +
| +
| -
| -
|
* No changes seen
|[[Doxycycline]]
|[[Doxycycline]]
|-
|-
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| +
| +
| -
| -
|
* Minimal changes observed
| -
| -
| -
| -
| -
| -
|
* Minimal changes observed
|[[Doxycycline]], [[azithromycin]]
|[[Doxycycline]], [[azithromycin]]
|-
|-
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| -
| -
| -
| -
| -
| -
| +
|
|
* Bronchial wall thickening
* Bronchial wall thickening
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* [[Ground glass opacification on CT|Ground-glass attenuation]]  
* [[Ground glass opacification on CT|Ground-glass attenuation]]  
* [[Consolidation (medicine)|Consolidation]]  
* [[Consolidation (medicine)|Consolidation]]  
| -
| -
| +
|[[Doxycycline]]
|[[Doxycycline]]
|-
|-
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| ++
| ++
| +
| +
|
*Often multifocal
| ++
| ++
| +
| +
| ++
| ++
|
*Often multifocal
|[[Doxycycline]]
|[[Doxycycline]]
|-
|-
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| +/-
| +/-
| +/-
| +/-
| -
| -
| -
|
|
* Bi-basal air-space opacities
* Bi-basal air-space opacities
* Perihilar [[reticular]] and [[Alveolar|alveolar infiltrates]]
* Perihilar [[reticular]] and [[Alveolar|alveolar infiltrates]]
| -
| -
| -
|[[Zanamivir]], [[oseltamivir]]
|[[Zanamivir]], [[oseltamivir]]
|-
|-
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| -
| -
| -
| -
|
* Hazy opacities at [[lung]] bases bilaterally
| -
| -
| +/-
| +/-
| +/-
| +/-
|
* Hazy opacities at [[lung]] bases bilaterally
|[[Vancomycin]]
|[[Vancomycin]]
|-
|-
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| +/-
| +/-
|Minimal
|Minimal
| -
| +/-
|=/-
|
|
* [[Segmental analysis (biology)|Segmental]] or [[Lobar pneumonia|lobar]] opacification
* [[Segmental analysis (biology)|Segmental]] or [[Lobar pneumonia|lobar]] opacification
* Occasional [[pleural effusions]]
* Occasional [[pleural effusions]]
| -
| +/-
|=/-
|[[Doxycycline]]
|[[Doxycycline]]
|-
|-
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| ++
| ++
| -
| -
| +++
|
|
* Multiple  ill-defined  [[Nodule (medicine)|nodules]]  in  both  lungs.
| +++
|
|
|
|
* Multiple  ill-defined  [[Nodule (medicine)|nodules]]  in  both  lungs.
|[[Doxycycline]], [[azithromycin]], [[amoxicillin]]
|[[Doxycycline]], [[azithromycin]], [[amoxicillin]]
|-
|-
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| +
| +
| -
| -
| -/+
| +/-
| +/-
|
|
* Soft [[Miliary TB|miliary]] mottling
* Soft [[Miliary TB|miliary]] mottling
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* [[Hilar]] or [[Paratracheal lymph nodes|paratracheal]] [[lymphadenopathy]]
* [[Hilar]] or [[Paratracheal lymph nodes|paratracheal]] [[lymphadenopathy]]
* [[Pneumothorax]]
* [[Pneumothorax]]
| -/+
| +/-
| +/-
|[[Doxycycline]], [[rifampin]]
|[[Doxycycline]], [[rifampin]]
|}
|}

Revision as of 15:48, 14 August 2017

Psittacosis Microchapters

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Differentiating Psittacosis from other Diseases

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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 and 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 that can only be differentiated by taking appropriate histories and laboratory investigations. There are other conditions to watch out for which may also present similarly to psittacosis.

Differentiating Psittacosis from other Diseases

The following diseases must be differentiated from psittacosis based on the presentation of cough, fever, myalgia, and shortness of breath.[1][2]

Differentiating psittacosis from other diseases

Disease Clinical Manifestations Lab findings Imaging findings Main treatment
Cough Sputum Dyspnea Sore throat Headache Confusion Diarrhea Hyponatremia Leukopenia Abnormal Liver function tests
Psittacosis ++ - + - +++ + Minimal - + -
  • No changes seen
 Doxycycline
C.pneumoniae pneumonia + + + +++ ++ + - - - -
  • Minimal changes observed
 Doxycycline, azithromycin
M. pneumoniae pneumonia ++ ++ ++ - - - - - - + Doxycycline
L. pneumophila infection + +++ +++ - + ++ + ++ + ++
  • Often multifocal
 Doxycycline
Influenza ++ ++ ++ ++ ++ +/- +/- - - - Zanamivir, oseltamivir
Endocarditis ++ ++ + - - - - - +/- +/-
  • Hazy opacities at lung bases bilaterally
 Vancomycin
Coxiella burnetii infection ++ - + +/- - +/- Minimal - +/- =/- Doxycycline
Leptospirosis ++ + ++ + + ++ - +++
  • Multiple ill-defined nodules in both lungs.
 Doxycycline, azithromycin, amoxicillin
Brucellosis ++ - + - ++ + - -/+ +/- +/- Doxycycline, rifampin

Key;

+, occurs in some cases

++, occurs in many cases,

+++, occurs frequently

References

  1. ↑ Yung AP, Grayson ML (1988). "Psittacosis--a review of 135 cases". Med J Aust. 148 (5): 228–33. PMID 3343952.
  2. ↑ Raoult D, Marrie T (1995). "Q fever". Clin Infect Dis. 20 (3): 489–95, quiz 496. PMID 7756465.
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