Pneumothorax differential diagnosis

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

Complete Differential Diagnosis of Underlying Causes of Pneumothorax

Causes

• Acupuncture
• Bacterial pneumonia with abscess
• Barotrauma
• Blunt trauma
• Bronchial asthma
• Cancer
• Catamenial pneumothorax (due to endometriosis in the chest cavity)
• Central bronchial carcinoma
• Coccidiomycosis
• Cystic Fibrosis
• Ehlers-Danlos Syndrome
• Emphysema
• Eosinophilic Granuloma
• Hydatid lung disease
• Lung emphysema
• Marfan's Syndrome
• Mechanical ventilation
• Medastinal emphysema
• Paragonimiasis
• Positive end expiratory pressure or PEEP
• Pneumoconiosis
• Penetrating trauma
• Pneumocystis carinii pneumonia
• Pseudoxanthoma elasticum
• Primary spontaneous pneumothorax
• Pulmonary lymphangiomatoid granulomatosis
• Pulmonary hemosiderosis
• Rheumatoid lung disease
• Rupture of cysts
• Sarcoidosis
• Spontaneously (most commonly in tall slim young males and in Marfan syndrome)
• Sudden chest compression
• Tuberculosis

Differential Diagnosis of Conditions that Pneumothorax must be Distinguished From

• Acute Myocardial Infarction: presents with shortness of breath and chest pain, though MI chest pain is characteristically crushing, central and radiating to the jaw, left arm or stomach. While not a lung condition, patients having an MI often happen to also have lung disease.
• Emphysema: here, delicate functional lung tissue is lost and replaced with air spaces, giving shortness of breath, and decreased air entry and increased resonance on examination. However, it is usually a chronic condition, and signs are diffuse (not localised as in pneumothorax).

A careful history, physical examination and a chest x-ray will allow the conditions to be differentiated.