Psittacosis differential diagnosis: Difference between revisions

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{{CMG}}; {{AE}} {{ADI}}{{DAMI}}
{{CMG}}; {{AE}} {{ADI}}{{DAMI}}
==Overview==
==Overview==
[[Psittacosis]] must be differentiated from other diseases that cause [[atypical pneumonia|atypical pneumonia,]] [[Febrile|febrile illness]] without localizing signs and extrapulmonary manifestations such as [[gastroenteritis]], [[hepatitis]], [[meningitis]], or [[encephalitis]]. The three main [[diseases]] to differentiate psittacosis from are [[Chlamydia pneumoniae|''Chlamydia pneumoniae'']], [[Mycoplasma pneumoniae|''Mycoplasma pneumoniae'']], and [[Legionella infection]] as they tend to have similar clinical manifestations which can only be differentiated by taking appropriate [[History & Symptoms|histories]] and [[Laboratory|laboratory investigations]]. There are other conditions to watch out for which may also present similar to psittacosis.
[[Psittacosis]] must be differentiated from other [[diseases]] that cause [[atypical pneumonia]] and [[febrile]] [[illness]] without localizing signs and extrapulmonary manifestations such as [[gastroenteritis]], [[hepatitis]], [[meningitis]], or [[encephalitis]]. The three main [[diseases]] to differentiate psittacosis from are ''[[Chlamydia pneumoniae]]'', ''[[Mycoplasma pneumoniae]]'', and [[Legionella infection|''Legionella'' infection]], as they tend to have similar clinical manifestations that can only be differentiated by taking appropriate histories and [[Laboratory information system|laboratory investigations]]. There are other conditions to watch out for which may also present similarly to psittacosis.


==Differentiating Psittacosis from other Disease<ref name="pmid3343952">{{cite journal| author=Yung AP, Grayson ML| title=Psittacosis--a review of 135 cases. | journal=Med J Aust | year= 1988 | volume= 148 | issue= 5 | pages= 228-33 | pmid=3343952 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3343952  }} </ref><ref name="pmid7756465">{{cite journal| author=Raoult D, Marrie T| title=Q fever. | journal=Clin Infect Dis | year= 1995 | volume= 20 | issue= 3 | pages= 489-95; quiz 496 | pmid=7756465 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7756465  }} </ref>==
==Differentiating Psittacosis from other Disease<ref name="pmid3343952">{{cite journal| author=Yung AP, Grayson ML| title=Psittacosis--a review of 135 cases. | journal=Med J Aust | year= 1988 | volume= 148 | issue= 5 | pages= 228-33 | pmid=3343952 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3343952  }} </ref><ref name="pmid7756465">{{cite journal| author=Raoult D, Marrie T| title=Q fever. | journal=Clin Infect Dis | year= 1995 | volume= 20 | issue= 3 | pages= 489-95; quiz 496 | pmid=7756465 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7756465  }} </ref>==
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| -
| -
| -
| -
|[[Doxycycline]], [[Azithromycin]]
|[[Doxycycline]], [[azithromycin]]
|-
|-
|[[Mycoplasma pneumoniae|''M. pneumoniae'']] pneumonia
|[[Mycoplasma pneumoniae|''M. pneumoniae'']] pneumonia
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|[[Doxycycline]]
|[[Doxycycline]]
|-
|-
|[[Legionella pneumophila|''L. Pneumophila'']] infection
|[[Legionella pneumophila|''L. pneumophila'']] infection
| +
| +
| +++
| +++
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| ++
| ++
| +
| +
|Often Multifocal
|Often multifocal
| ++
| ++
| +
| +
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| -
| -
| -
| -
|[[zanamivir]], [[oseltamivir]],
|[[Zanamivir]], [[oseltamivir]]
|-
|-
|[[Endocarditis]]
|[[Endocarditis]]
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| -
| -
|
|
* Hazy opacities at [[lung]]
* Hazy opacities at [[lung]] bases bilaterally
bases bilaterally
| -
| -
| +/-
| +/-
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* [[Chronic (medical)|Chronic]] [[diffuse]] changes
* [[Chronic (medical)|Chronic]] [[diffuse]] changes
* [[Hilar]] or [[Paratracheal lymph nodes|paratracheal]] [[lymphadenopathy]]
* [[Hilar]] or [[Paratracheal lymph nodes|paratracheal]] [[lymphadenopathy]]
* [[Pneumothorax]].
* [[Pneumothorax]]
| -/+
| -/+
| +/-
| +/-

Revision as of 17:16, 9 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]Omodamola Aje B.Sc, M.D. [3]

Overview

Psittacosis must be differentiated from other diseases that cause atypical pneumonia and febrile illness without localizing signs and extrapulmonary manifestations such as gastroenteritis, hepatitis, meningitis, or encephalitis. The three main diseases to differentiate psittacosis from are Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella infection, as they tend to have similar clinical manifestations that can only be differentiated by taking appropriate histories and laboratory investigations. There are other conditions to watch out for which may also present similarly to psittacosis.

Differentiating Psittacosis from other Disease[1][2]

The following diseases must be differentiated from psittacosis based on the presentation of cough, fever, myalgia, and shortness of breath.

Differentiating psittacosis from other diseases

Clinical feature Cough Sputum Dyspnea Sore throat Headache Confusion Diarrhea Chest radiograph changes Hyponatremia Leukopenia Abnormal Liver function tests Treatment
Psittacosis ++ - + - +++ + Minimal
  • No changes seen
 - + - Doxycycline
C.pneumoniae pneumonia + + + +++ ++ + -
  • Minimal changes observed
 - - - Doxycycline, azithromycin
M. pneumoniae pneumonia ++ ++ ++ - - - - - - + Doxycycline
L. pneumophila infection + +++ +++ - + ++ + Often multifocal ++ + ++ Doxycycline
Influenza ++ ++ ++ ++ ++ +/- +/- - - - Zanamivir, oseltamivir
Endocarditis ++ ++ + - - - -
  • Hazy opacities at lung bases bilaterally
 - +/- +/- Vancomycin
Coxiella burnetii infection ++ - + +/- - +/- Minimal - +/- =/- Doxycycline
Leptospirosis ++ + ++ + + ++ -
  • Multiple ill-defined nodules in both lungs.
 +++ Doxycycline, azithromycin, amoxicillin
Brucellosis ++ - + - ++ + - -/+ +/- +/- Doxycycline, rifampin

Key;

+, occurs in some cases

++, occurs in many cases,

+++, occurs frequently

References

  1. ↑ Yung AP, Grayson ML (1988). "Psittacosis--a review of 135 cases". Med J Aust. 148 (5): 228–33. PMID 3343952.
  2. ↑ Raoult D, Marrie T (1995). "Q fever". Clin Infect Dis. 20 (3): 489–95, quiz 496. PMID 7756465.
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