Bacterial pneumonia differential diagnosis: Difference between revisions

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'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' [[User:AroojNaz|Arooj Naz]]<br />
'''Editor-In-Chief:''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] [Mailto:charlesmichaelgibson@gmail.com| <nowiki>[1]</nowiki>]; '''Associate Editor(s)-in-Chief:''' [[User:AroojNaz|Arooj Naz, M.B.B.S]]<br />
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{{Bacterial pneumonia}}
{{Bacterial pneumonia}}
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|+'''Differential Diagnosis of Pneumonia by Infectious Agent'''
|+'''Differential Diagnosis of Pneumonia by Infectious Agent'''
! style="background: #4479BA; width: 200px;" |{{fontcolor|#FFF|Disease}}
! style="background: #4479BA; width: 200px;" |{{fontcolor|#FFF|Disease}}
! style="background: #4479BA; width: 500px;" |{{fontcolor|#FFF|Findings}}
! style="background: #4479BA; width: 500px;" |{{fontcolor|#FFF|Common Organisms}}
! style="background: #4479BA; width: 500px;" |{{fontcolor|#FFF|Common Organisms}}
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|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Typical Bacterial
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Typical Bacterial
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |[[S. pneumoniae]], [[H. influenzae]], [[S. aureus]], [[Klebsiella pneumoniae]], [[anaerobes]], [[group A streptococci]], [[Moraxella catarrhalis]]
| style="padding: 5px 5px; background: #F5F5F5;" |[[S. pneumoniae]], [[H. influenzae]], [[S. aureus]], [[Klebsiella pneumoniae]], [[anaerobes]], [[group A streptococci]], [[Moraxella catarrhalis]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Atypical Bacterial
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Atypical Bacterial
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |[[Mycoplasma pneumoniae]], [[Legionella]] spp, [[Chlamydophila pneumoniae]], and C. psittaci
| style="padding: 5px 5px; background: #F5F5F5;" |[[Mycoplasma pneumoniae]], [[Legionella]] spp, [[Chlamydophila pneumoniae]], and C. psittaci
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Viral
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Viral
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |[[Influenza]] virus, [[Parainfluenza virus|Parainfluenza]] virus, [[Adenovirus]], [[Rhinovirus]], [[RSV]], [[SARS]], [[MERS-CoV]]
| style="padding: 5px 5px; background: #F5F5F5;" |[[Influenza]] virus, [[Parainfluenza virus|Parainfluenza]] virus, [[Adenovirus]], [[Rhinovirus]], [[RSV]], [[SARS]], [[MERS-CoV]]
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Fungi
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Fungi
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |[[Cryptococcus]] spp, [[Pneumocystis jirovecii]],  [[Histoplasma capsulatum]], [[Coccidioides spp|Coccidioides]] spp, [[Aspergillus]] spp
| style="padding: 5px 5px; background: #F5F5F5;" |[[Cryptococcus]] spp, [[Pneumocystis jirovecii]],  [[Histoplasma capsulatum]], [[Coccidioides spp|Coccidioides]] spp, [[Aspergillus]] spp
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Parasite
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Parasite
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
|}
|}
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[[Category:Pneumonia]]
[[Category:Pneumonia]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:needs english review]]
[[Category:Up to date]]


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Latest revision as of 16:31, 1 December 2022

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S

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Overview

Symptoms related to pulmonary diseases may overlap, and so, it is important to differentiate bacterial causes from other diseases. This can be done with the assistance of laboratory examinations such as chest x-ray findings, throat cultures, and sensitivity bacterial cultures. Some pulmonary diseases that must be differentiated include bronchitis, bronchiolitis obliterans, empyema, lung abscess, and pulmonary carcinomas. Other diseases to be ruled out include bacterial endocarditis, especially in patients with an underlying history of intravenous drug abuse, GERD, and sinusitis.

Differentiating Bacterial Pneumonia from other Diseases

Differential Diagnosis of Pneumonia by Infectious Agent
Disease Common Organisms
Typical Bacterial S. pneumoniae, H. influenzae, S. aureus, Klebsiella pneumoniae, anaerobes, group A streptococci, Moraxella catarrhalis
Atypical Bacterial Mycoplasma pneumoniae, Legionella spp, Chlamydophila pneumoniae, and C. psittaci
Viral Influenza virus, Parainfluenza virus, Adenovirus, Rhinovirus, RSV, SARS, MERS-CoV
Fungi Cryptococcus spp, Pneumocystis jirovecii, Histoplasma capsulatum, Coccidioides spp, Aspergillus spp
Parasite


Differential Diagnosis of Pneumonia [1][2][3]
Disease Findings
Acute bronchitis No infiltrates seen on the chest X-ray
Asthma Past medical history, no infiltrates seen on chest X-ray
Bronchiolitis obliterans Should be suspected in patients with pneumonia who do not respond to antibiotics treatment
Congestive heart failure Bilateral pulmonary edema, shortness of breath
COPD Past medical history, no infiltrates on chest X-ray, fever is uncommon
Empyema CXR showing features of pleural effusion, inflammatory markers on thoracocentesis
Endocarditis Finding of septic pulmonary emboli
Gastroesophageal reflux disease (GERD) Normal chest X-ray, symptoms are worse during night and associated with meals
Lung abscess Chest X-ray shows signs of lung abscess
Lung cancer Weight loss and clear sputum. CT scan and biopsy are helpful in ruling out malignancy
Pertussis Productive cough for weeks, nasopharyngeal aspirate aids in diagnosis
Pulmonary embolus A high degree of suspicion should be kept for pulmonary embolus. Chest X-ray may be normal
Sinusitis Sinus tenderness, post nasal drip
Vasculitis Systemic manifestations of collagen vascular disease may be seen

References

  1. Schiele F, Muller J, Colinet E, Siest G, Arzoglou P, Brettschneider H; et al. (1992). "Interlaboratory study of the IFCC method for alanine aminotransferase performed with use of a partly purified reference material". Clin Chem. 38 (12): 2365–71. PMID 1458569.
  2. Castro-Guardiola A, Armengou-Arxé A, Viejo-Rodríguez A, Peñarroja-Matutano G, Garcia-Bragado F (2000). "Differential diagnosis between community-acquired pneumonia and non-pneumonia diseases of the chest in the emergency ward". Eur J Intern Med. 11 (6): 334–339. PMID 11113658.
  3. Ahnsjö, Sven (1935). "Contribution to the Differential Diagnosis of Pneumonia in Childhood". Acta Paediatrica. 17 (3): 439–446. doi:10.1111/j.1651-2227.1935.tb07697.x. ISSN 0803-5253.

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