Pneumonic plague differential diagnosis
Template:Pneumonic plague Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Differentiating Pneumonic Plague from other Diseases
- Inhalational anthrax (Bacillus anthracis)
- Widened mediastinum and pleural effusions seen on CXR or chest CT.
- Not true pneumonia; minimal sputum production.
- Hemoptysis uncommon (if present, suggests diagnosis of plague).
- Tularemia (Francisella tularensis)
- Clinical course not as rapid or fulminant as in pneumonic plague.
- Mycoplasmal pneumonia (Mycoplasma pneumoniae)
- Rarely as fulminant as pneumonic plague.
- Pneumonia caused by Chlamydia pneumoniae
- Rarely as fulminant as pneumonic plague.
- Legionnaires' disease (Legionella pneumophila or other Legionella species)
- Rarely as fulminant as pneumonic plague.
- Community outbreaks of Legionnaires' disease often involve exposure to cooling systems.
- Legionellosis and many other diseases caused by bacterial agents (S aureus, S pneumoniae, H influenzae, K pneumoniae, M catarrhalis) usually occur in persons with underlying pulmonary or other disease or in the elderly.
- Psittacosis (Chlamydia psittaci)
- Rarely as fulminant as pneumonic plague.
- Result of bird exposure.
- Other bacterial agents (e.g., Staphyloccocus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Moraxella catarrhalis)
- Rarely as fulminant as pneumonic plague.
- Usually occur in persons with underlying pulmonary or other disease or in the elderly.
- Influenza
- Influenza generally seasonal (October-March in United States) or involves history of recent cruise ship travel or travel to tropics.
- Hantavirus
- Exposure to excrement (urine or feces) of mice with Hantavirus.
- RSV
- RSV usually occurs in children (although may be cause of pneumonia in elderly); tends to be seasonal (winter/spring).
- CMV
- CMV usually occurs in immunocompromised patients.
- Q fever (Coxiella burnetii)
- Exposure to infected parturient cats, cattle, sheep, goats.
- Severe pneumonia not prominent feature.