Sandbox: Bronchiolitis DD

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Diseases Symptoms Signs Diagosis
Lab tests Imaging
Bronchiolitis
  • No specific lab findings
  • Viral tests like ELISA and immunoassays may be done in case of RSV infection.
  • Pulmonary function test is performed to exclude other lung diseases.
No specific imaging findings.
Asthma
  • Lab tests are not specific for asthma but they are performed to exclude other diseases.
  • Serum examination shows elevated level of esoinophils due to allergy.
CT scan shows dilated bronchi, bronchial wall thickening and air trapping.[1]
COPD
Bacterial pneumonia
Pulmonary embolism
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia
Influenza
Common cold
Tuberculosis
Interstitial pneumonitis (Hamman - Rich syndrome)
Foreign body aspiration
Sarcoidosis
Pertussis
  • Nasopharyngeal swab
  • Culture
  • Serology to detect pertussis toxin.
No remarkable imaging findings.

Differential diagnosis of bronchiolitis: Asthma, COPD, sarcoidosis, pneumonia, heart failure, DIPNECH, foreign body inhalation, pulmonary embolism and GERD (in case it is associated with asthma).

  1. Park CS, Müller NL, Worthy SA, Kim JS, Awadh N, Fitzgerald M (1997) Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings. Radiology 203 (2):361-7. PMID: 9114089