Community-acquired pneumonia differential diagnosis: Difference between revisions
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Latest revision as of 21:02, 29 July 2020
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Community-Acquired Pneumonia Microchapters |
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Differentiating Community-acquired pneumonia from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Community-acquired pneumonia differential diagnosis On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pneumonia should be differentiated from other conditions that cause cough, fever, shortness of breath and tachypnea, such as asthma, COPD, CHF, cancer, GERD, and 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, such as unilateral and single mass involving posterior segments of the upper lobes, air-fluid levels may be seen. |
| 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 in patients with a sudden onset of chest pain. Chest X ray may be normal. Fever could be present. |
| 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 |
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| Adapted from N Engl J Med 2014; 370:543-551[4] | |
References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.