Sandbox: Bronchiolitis DD: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 60: Line 60:
* Sputum culture   
* Sputum culture   
|
|
* EKG may show P pulmonale, right ventricular hypertrophy and low QRS.  
* EKG may show P pulmonale, right ventricular hypertrophy and low QRS.<ref name="pmid23653989">{{cite journal| author=Lazović B, Svenda MZ, Mazić S, Stajić Z, Delić M| title=Analysis of electrocardiogram in chronic obstructive pulmonary disease patients. | journal=Med Pregl | year= 2013 | volume= 66 | issue= 3-4 | pages= 126-9 | pmid=23653989 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23653989  }} </ref>
|-
|-
|Bacterial pneumonia  
|Bacterial pneumonia  

Revision as of 17:21, 22 June 2017

Bronchiolitis should be differentiated with other diseases that cause cough and dysnea.

Diseases Symptoms Signs Diagosis
Fever Cough Chest pain Wheezes Crackles Edema Tachycardia Lab tests Imaging
Bronchiolitis +/- Dry - + + - +/-
  • No specific lab findings
  • Viral tests like ELISA and immunoassays may be done in case of RSV infection.
  • Pulmonary function test is performed to exclude other lung diseases.[1]
  • Ct scan shows Intense bronchiolar mural inflammation of cellular bronchiolitis results in centrilobular nodulesthat are usually associated with the tree-in-bud pattern and bronchial wall thickening
Asthma - Dry/Productive - + - + Pulmonary edema -
  • Lab tests are not specific for asthma but they are performed to exclude other diseases.
  • Serum examination shows elevated level of esoinophils due to allergy.
  • CT scan shows dilated bronchi, bronchial wall thickening and air trapping.
COPD + Productive + + + +
  • Spirometry: FEV1/FVC < 70%
  • Atrial blood gases: hypoxemia and hypercapnia
  • Sputum culture
  • EKG may show P pulmonale, right ventricular hypertrophy and low QRS.[2]
Bacterial pneumonia + Productive
Pulmonary embolism - Bloody + +
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia[3] - Dry - + -
  • Pulmonary function test shows obstructive lung disease
  • CT scan shows multiple nodules , ground glass appearance and bronchiectasis.
Tuberculosis + Bloody
Interstitial pneumonitis (Hamman - Rich syndrome) + Productive
Foreign body aspiration - Dry
Sarcoidosis - Dry
Pertussis + Dry - -
  • Nasopharyngeal swab
  • Culture
  • Serology to detect pertussis toxin.[4][5]
  • No remarkable imaging findings.
Congestive heart failure - Dry/Productive + while walking - - + +
  • Routine lab tests in order to know the cause of the heart failure:
    • Renal function tests including urinalysis and electrolytes assessment
    • Complete blood count
    • Thyroid studies specially in patients who are being treated with concomitant therapy with an agent such as amiodarone.
  • Biomarkers:
    • Natriuretic Peptides: BNP or NT-proBNP[6]
    • Biomarkers of myocardial Injury: Cardiac Troponin T or I
    • Carbohydrate Antigen 125[7]
  • EKG can be performed to detect the underlaying cause.
  • Chest x ray shows cardiomegaly.
  • Echocardiography is used to determine the stroke volume and to assess the heart failure.[8]

Differential diagnosis of bronchiolitis: Asthma, COPD, sarcoidosis, pneumonia, heart failure, DIPNECH, foreign body inhalation, pulmonary embolism and GERD (in case it is associated with asthma).

References

  1. ↑ Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM; et al. (2008). "An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients". Respir Med. 102 (6): 825–30. doi:10.1016/j.rmed.2008.01.016. PMID 18339530.
  2. ↑ Lazović B, Svenda MZ, Mazić S, Stajić Z, Delić M (2013). "Analysis of electrocardiogram in chronic obstructive pulmonary disease patients". Med Pregl. 66 (3–4): 126–9. PMID 23653989.
  3. ↑ Nassar AA, Jaroszewski DE, Helmers RA, Colby TV, Patel BM, Mookadam F (2011). "Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia: a systematic overview". Am J Respir Crit Care Med. 184 (1): 8–16. doi:10.1164/rccm.201010-1685PP. PMID 21471097.
  4. ↑ Pertussis (whooping coug). Diagnosis confirmation. CDC.gov. Accessed on June 22, 2017
  5. ↑ Pertussis (whooping cough). Specimen collection. CDC.gov. Accessed on June 22, 2017
  6. ↑ Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (2013). "2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J. Am. Coll. Cardiol. 62 (16): e147–239. doi:10.1016/j.jacc.2013.05.019. PMID 23747642.
  7. ↑ D'Aloia A, Vizzardi E, Metra M (2016). "Can Carbohydrate Antigen-125 Be a New Biomarker to Guide Heart Failure Treatment?: The CHANCE-HF Trial". JACC Heart Fail. 4 (11): 844–846. doi:10.1016/j.jchf.2016.09.001. PMID 27810078.
  8. ↑ Agha SA, Kalogeropoulos AP, Shih J, Georgiopoulou VV, Giamouzis G, Anarado P, Mangalat D, Hussain I, Book W, Laskar S, Smith AL, Martin R, Butler J (2009). "Echocardiography and risk prediction in advanced heart failure: incremental value over clinical markers". J. Card. Fail. 15 (7): 586–92. doi:10.1016/j.cardfail.2009.03.002. PMID 19700135.
Retrieved from "https://www.wikidoc.org/index.php?title=Sandbox:_Bronchiolitis_DD&oldid=1320220"