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

The following are the differentials of pneumonia depending on chest radiograph

Abnormal chest radiograph

• Congestive heart failure accompanied by viral infection
• Aspiration pneumonitis
• Pulmonary infarction
• Acute exacerbation of pulmonary fibrosis
• Acute exacaerbation of bronchiectasis
• Acute eosinophilic pneumonia
• Hypersensitivity pneumonitis
• Pulmonary vasculitis
• Cocaine-induced lung injury

Normal chest radiograph

• Acute exacerbation of chronic obstructive pulmonary disease
• Influenza
• Acute bronchitis
• Pertussis
• Asthma with viral syndrome