Community-acquired pneumonia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differentiating Pneumonia From Other Diseases

Acute bronchitis - No infiltrates on the CXR.
Asthma- No infiltrates on the CXR.
Bronchiolitis obliterans with organizing pneumonia should be suspected in patients who fail to respond to antibiotics.
Congestive heart failure - Bilateral pulmonary edema, involving more than the lower lung fields.
Chronic obstructive pulmonary disease - No infiltrates on the CXR.
Empyema - Pleural effusions on the CXR; positive inflammatory markers on pleural fluid anaylsis.
Endocarditis with septic pulmonary emboli
Gastroesophageal reflux disease - Normal CXR, symptoms worsen at 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. CXR may be insiginificant.
Sinusitis - Sinus tenderness, post-nasal drip.
Upper respiratory tract infection
Vasculitis - Systemic manifestations of collagen vascular disease may be seen.