Bronchiectasis differential diagnosis
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Overview
Bronchiectasis Differential Diagnosis
- Chronic Obstructive Pulmonary Disease (COPD)
- Diminished breath sounds in COPD are not found in bronchiectasis
- Chest CT will be normal or show emphysema is patients with COPD
- Asthma
- Crackles found in bronchiectasis will not be found in asthma
- Airflow obstruction is reversible in asthma
- Pneumonia
- Patients with pneumonia will express symptoms for a short duration of 7-10 days, whereas patients with bronchiectasis express symptoms for years
- Patients with pneumonia have bronchial breath sounds on auscultation
- Consolidation is seen on chest x-ray and chest CT in patients with pneumonia
- Tuberculosis
- Chronic Sinusitis
- Crackles found in bronchiectasis will not be found in chronic sinusitis
- Chest x-ray and chest CT are normal in chronic sinusitis
- Cough due to gastrointestinal reflux
- Upper airway cough syndrome (postnasal drip)
- Cancer of the lung
- Inhaled foreign body
Features that may suggest bronchiectasis in a patient presenting with chronic respiratory symptoms
- Digital clubbing
- Lack of a significant smoking history if you suspect a patient has COPD
- History of recurrent and/or severe pneumonia or tuberculosis
- Presence of Aspergillus, atypical/nontuberculous mycobacteria, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae in the sputum
- If the childhood is associated with significant environmental and social disadvantage