Community-acquired pneumonia differential diagnosis

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Differentiating Pneumonia from other Diseases

• Acute bronchitis - No infiltrates on the CXR.
• Asthma- No infiltrates on chest X Ray.
• Bronchiolitis obliterans with organizing pneumonia should be suspected in patients who don't respond to antibiotics treatment.
• Congestive heart failure - Bilateral pulmonary edema, involving more than the lower lung fields.
• COPD - No infiltrates on chest X Ray.
• Empyema - CXR showing features of pleural effusion, inflammatory markers on thoracocentesis.
• Endocarditis with septic pulmonary emboli
• Gastroesophageal reflux disease - Normal chest X Ray, symptoms worsening during night.
• Influenza
• Lung abscess - CXR showing signs of lung abscess.
• Malignancy - 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. Chest X Ray may be normal.
• Sinusitis - Sinus tenderness, post nasal drip.
• Upper respiratory tract infection
• Vasculitis - Systemic manifestations of collagen vascular disease may be seen.

Differential Diagnosis of Community acquired pneumonia depending on Chest radiograph

Abnormal chest radiograph

• Congestive heart failure accompanied by viral infection