Legionellosis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.
Overview
Legionellosis must be differentiated from other causes of fever, dyspnea, cough, and sputum production, such as bacterial pnuemonia, viral pneumonia, and other causes of atypical pnuemonia.
Differential Diagnosis
The following conditions must be considered in the differential diagnosis of Legionnaires' disease:
DDx [1][2][3][4][5][6][7]- Acute interstitial pneumonia
DDx - Mycoplasma pneumonia
DDx - Pneumococcal pneumonia
DDx - Pneumocystis carinii pneumonia
DDx - Pulmonary embolism
DDx - Streptococcal pneumonia
DDx - Viral pneumonia
DDx
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Mahshid Mir, M.D. [3]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- High grade fever
- Dry cough
- Progressive dyspnea
- Bronchial breath sounds
- Adult respiratory distress syndrome
Laboratory abnormalities
- Legionella urinary antigen positive
- Alveolar consolidation on chest radiograph
- Lobar consolidation on chest radiograph
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4] Mahshid Mir, M.D. [5]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Dry cough
- Progressive dyspnea
- Adult respiratory distress syndrome
Laboratory abnormalities
- Disseminated consolidation on chest radiograph
- Interstitial infiltrate on chest radiograph
- Increased uptake on Gallium scan
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [6] Mahshid Mir, M.D. [7]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Dry cough
- Pleuritic chest pain
- Inflammed, opaque, hypomobile tympanic membrane
- Bronchial breath sounds
Laboratory abnormalities
- Lymphocytosis
- Cold agglutinins positive
- Alveolar consolidation on chest radiograph
- Interstitial infiltrate on chest radiograph
- Lobar consolidation on chest radiograph
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [8] Mahshid Mir, M.D. [9]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Hemoptysis
- Fine rales
- Pleuritic chest pain
- Increased breath sounds
- Bronchial breath sounds
- Dullness on chest percussion
- Purulent sputum
- Shallow respiration
- Pectoriloquy
- Increased tactile fremitus
- Productive cough
- Egophony
- High grade fever
Laboratory abnormalities
- Pleural effusion (exudative)
- Respiratory alkalosis
- Parenchymal hyperlucency on chest radiograph
- Increased uptake on Gallium scan
- Unilateral diaphragm elevation on chest radiograph
- Alveolar consolidation on chest radiograph
- Lobar consolidation on chest radiograph
- Gram positive diplococci on sputum Gram stain
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [10] Mahshid Mir, M.D. [11]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Immunosuppressive state
- Mediastinal emphysema
- Subcutaneous emphysema
- Hacking cough
- Progressive dyspnea
Laboratory abnormalities
- Respiratory alkalosis
- Serum beta-D-glucan elevated
- Alveolar consolidation on chest radiograph
- Lobar consolidation on chest radiograph
- Interstitial infiltrate on chest radiograph
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [12] Mahshid Mir, M.D. [13]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Calf pain / swelling
- Decreased pulse pressure
- Dyspnea with normal chest X-ray
- Hemoptysis
- Hyperventilation
- Immobility
- Increased pulmonic component of heart sound
- Pleuritic chest pain
- Prior DVT
- Pulmonary hypertension
- Right ventricular heave
- Right ventricular hypertrophy
- Right-to-left shunt
- Substernal chest pain
- Tachypnea
- Thrombophlebitis
- Unilateral lower extremity edema
- Venous stasis
Laboratory abnormalities
- Atrial fibrillation
- Bone fracture
- Atelectasis on chest radiograph
- Lobar consolidation on chest radiograph
- Prominent pulmonary artery on chest radiograph
- Hampton's hump on chest radiograph
- D-dimer elevated
- Right ventricular enlargement on echocardiography
- Thrombus on echocardiography
- Hypocapnia
- Hypoxia
- Segmental perfusion defect on lung scan
- V/Q mismatch on lung scan
- Pleural effusion (exudative / bloody)
- RVH on ECG
- Right axis deviation on ECG
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [14] Mahshid Mir, M.D. [15]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Pectoriloquy
- Bronchial breath sounds
- Empyema
- Erythema nodosum
- Purulent sputum
- Shallow respiration
- Increased tactile fremitus
- Pleuritic chest pain
- Egophony
Laboratory abnormalities
- Respiratory alkalosis
- Pleural effusion (exudative)
- Increased uptake on Gallium scan
- Gram-positive cocci in chains on sputum Gram stain
- Alveolar consolidation on chest radiograph
- Lobar consolidation on chest radiograph
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [16] Mahshid Mir, M.D. [17]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Pleuritic chest pain
- Bronchial breath sounds
- Influenza
- Fine rales
- Bronchovesicular breath sounds
Laboratory abnormalities
- Lymphocytosis
- Respiratory alkalosis
- Lobar consolidation on chest radiograph
- Interstitial infiltrate on chest radiograph
References
- ↑ Ferri, Fred (2011). Ferri's differential diagnosis: a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323076999.
- ↑ Siegenthaler, Walter (2007). Differential diagnosis in internal medicine: from symptom to diagnosis. Stuttgart New York: Thieme. ISBN 978-1588905512.
- ↑ Mesko, Dusan (2002). Differential diagnosis by laboratory medicine: a quick reference for physicians. Berlin New York: Springer-Verlag. ISBN 978-3540430575.
- ↑ Reeder and Felson's gamuts in radiology: comprehensive lists of roentgen differential diagnosis. Place of publication not identified: Springer. 2014. ISBN 978-1475781229.
- ↑ Burgener, Francis (2008). Differential diagnosis in conventional radiology. Stuttgart New York: Thieme. ISBN 978-1588902757.
- ↑ Gattuso, Paolo (2015). Differential diagnosis in surgical pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1455770137.
- ↑ "DXplain".