Psittacosis differential diagnosis: Difference between revisions

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Revision as of 21:23, 26 July 2017

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]

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.

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

Table 1; Differentiating psittacosis 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	No changes seen	-	+	-	Doxycycline
C.pneumoniae	+	+	+	+++	++	+	-	Minimal changes observed	-	-	-	Doxycycline, Azithromycin
M. pneumoniae	++	++	++	-	-	-	-	Bronchial wall thickening Centrilobular nodules Ground-glass attenuation Consolidation	-	-	+	Doxycycline
L. Pneumophila	+	+++	+++	-	+	++	+	Often Multifocal	++	+	++	Doxycycline
Influenza	++	++	++	++	++	+/-	+/-	Bi-basal air-space opacities Perihilar reticular and alveolar infiltrates	-	-	-	zanamivir, oseltamivir,
Endocarditis	++	++	+	-	-	-	-	Hazy opacities at lung bases bilaterally	-	+/-	+/-	Vancomycin
Coxiella burnetii infection	++	-	+	+/-	-	+/-	Minimal	Segmental or lobar opacification Occasional pleural effusions	-	+/-	=/-	Doxycycline
Leptospirosis	++	+	++	+	+	++	-	Multiple ill-defined nodules in both lungs.	+++			Doxycycline, azithromycin, amoxicillin
Brucellosis	++	-	+	-	++	+	-	Soft miliary mottling Parenchymal nodules Consolidation Chronic diffuse changes Hilar or paratracheal lymphadenopathy Pneumothorax.	-/+	+/-	+/-	Doxycycline, rifampin

Key;

+, occurs in some cases

++, occurs in many cases,

+++, occurs frequently

↑ ^1.0 ^1.1 Yung AP, Grayson ML (1988). "Psittacosis--a review of 135 cases". Med J Aust. 148 (5): 228–33. PMID 3343952.
↑ Raoult D, Marrie T (1995). "Q fever". Clin Infect Dis. 20 (3): 489–95, quiz 496. PMID 7756465.

@@ Line 8: / Line 8: @@
 ==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>==
 The following [[diseases]] must be differentiated from [[psittacosis]] based on the presentation of [[cough]], [[fever]], [[myalgia]], and [[shortness of breath]].
-*''C. pneumoniae'' pneumonia
+*''[[C. pneumoniae]]'' [[pneumonia]]
-*''M. pneumoniae'' pneumonia
+*''[[M. pneumoniae]]'' [[pneumonia]]
 *[[Legionella infection|''L. pneumophila'' infection]]
@@ Line 20: / Line 20: @@
 *[[Brucellosis]]
-'''Table 1; Differentiating C.psittaci from other diseases'''
+'''Table 1; Differentiating psittacosis from other diseases'''
 {| class="wikitable"
 !Clinical feature