Aspiration pneumonia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karina Zavaleta, MD [2], Anmol Pitliya, M.B.B.S. M.D.[3]

Aspiration pneumonia differential diagnosis

Aspiration pneumonia must be differentiated from other diseases that cause productive cough, fever, and dyspnea.

Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Respiratory Foreing body aspiration[1][2][3] Acute
  • Variable
+ + + +
  • No specific tests
  • Not specific
  • In children <1 year and adults >75 years
  • Organic materials in children
  • Inorganic materials in adults
Croup[4] Acute
  • 3−5 days
+ + +
  • Clinical diagnosis.
  • Laboratory findings and imaging are not necessary for diagnosis
Pertussis[5][6] Acute
  • Two weeks
+ Whooping sound + + +
  • Clear chest
  • Normal function
  • Culture
Rhinosinusitis[7][8] Acute, subacute, chronic, recurrent
  • Acute: Less than 4 weeks
  • Subacute: 4−12 weeks
  • Chronic: More than 12 weeks
  • Recurrent: 4 or more episodes or acute rhinosinusitis per year
+ + +
  • Clear chest
  • Air−fluid level, mucosal edema and bony erosion of sinus on CT
  • MRI for distinguish the etiology
  • Normal function
Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Respiratory Acute Bronchitis[9] Acute
  • From 5 days to 1 or 3 weeks
+ +/− +
  • FEV1 < 80%
  • Clinical diagnosis
Chronic Bronchitis[10][11] Chronic
  • Most of the days for three months in the las two years.
+ Clear sputum + +
Emphysema [12] Chronic
  • Months to years
+ Mucoid or purulent sputum + +
  • Exposure of tobacco and air pollution
Bronchiolitis[13][14] Acute
  • 8−15 days
+ + +
  • Clinical diagnosis
Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Respiratory Pneumonia[15][16] Acute
  • Variable
+ Mucopurulent sputum + +
  • Not specific
Lung cancer[17][18] Chronic
  • Years
+ + + +/− + The following investigations may be helpful:
  • Not specific
Tuberculosis (TB)[19][20] Chronic
  • More than 2 or 3 weeks
+ + + + +
Cystic fibrosis (CF)[21][22] Chronic
  • Variable
+ + +/− +
  • Evidence of CFTR dysfunction
Organ system Diseases Clinical manifestations Diagnosis Other features
Symptoms Physical exam
Onset Duration Productive cough Hemoptysis Weight lost Fever Dyspnea Ascultation Lab findings Imaging PFT Gold standard
Autoimmune Wegener's disease (GPA) [23][24] Chronic
  • Months
+ + + + + The following investigations may be helpful:
Microscopic polyangitis (MPA)[25] Chronic
  • Variable
+ + + + + The following investigations may be helpful:
Churg−Strauss[26][27] Chronic
  • Variable
+ + + + +
  • Infiltrates in chest X−Ray
  • Ground glass opacities, tree−in−bud sign and small nodules in chest CT

References

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  2. Rafanan AL, Mehta AC (2001). "Adult airway foreign body removal. What's new?". Clin. Chest Med. 22 (2): 319–30. PMID 11444115.
  3. Haddadi S, Marzban S, Nemati S, Ranjbar Kiakelayeh S, Parvizi A, Heidarzadeh A (2015). "Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study". Iran J Otorhinolaryngol. 27 (82): 377–85. PMC 4639691. PMID 26568942.
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  6. "Pertussis | Whooping Cough | Clinical | Information | CDC".
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  14. "www.nice.org.uk".
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  16. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG (2007). "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults". Clin. Infect. Dis. 44 Suppl 2: S27–72. doi:10.1086/511159. PMID 17278083.
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