Pneumonia differential diagnosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2]
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Overview
Pneumonia should be differentiated from other conditions that cause cough, fever, shortness of breath and tachypnea, such as asthma, COPD, CHF, cancer, GERD, pulmonary emboli.
Differentiating Pneumonia from other Diseases
| Disease | Findings |
|---|---|
| Acute bronchitis | No infiltrates on the CXR. |
| Asthma | Past medical history, no infiltrates 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 |
| Malignancy | 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. Chest X Ray may be normal. |
| Sinusitis | Sinus tenderness, post nasal drip. |
| Vasculitis | Systemic manifestations of collagen vascular disease may be seen. |