Bacterial pneumonia differential diagnosis

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Overview

Bacterial Pneumonia has various subclassifications, all with distinct underlying causes. Prevalent organisms have been mentioned below.

Differentiating Bacterial Pneumonia from other Diseases

Differential Diagnosis of Pneumonia by Infectious Agent
Disease Findings 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, 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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