Legionellosis differential diagnosis: Difference between revisions
Jump to navigation
Jump to search
Gerald Chi- (talk | contribs) mNo edit summary |
Gerald Chi- (talk | contribs) mNo edit summary |
||
| Line 21: | Line 21: | ||
=====Clinical manifestations===== | =====Clinical manifestations===== | ||
* Adult respiratory distress syndrome | |||
* Bronchial breath sounds | |||
* Dry cough | |||
* High grade fever | * High grade fever | ||
* Progressive dyspnea | * Progressive dyspnea | ||
=====Laboratory abnormalities===== | =====Laboratory abnormalities===== | ||
* Legionella urinary antigen positive | * Legionella urinary antigen positive | ||
* Leukocytosis with relative lymphopenia | |||
* Hyponatremia | |||
* Hypophosphatemia | |||
=====Radiographic features===== | |||
* Alveolar consolidation on chest radiograph | * Alveolar consolidation on chest radiograph | ||
* Lobar consolidation on chest radiograph | * Lobar consolidation on chest radiograph | ||
| Line 39: | Line 44: | ||
* Dry cough | * Dry cough | ||
* Progressive dyspnea | * Progressive dyspnea | ||
=====Laboratory abnormalities===== | =====Laboratory abnormalities===== | ||
* Nonspecific | |||
=====Radiographic features===== | |||
* Disseminated consolidation on chest radiograph | * Disseminated consolidation on chest radiograph | ||
* Interstitial infiltrate on chest radiograph | * Interstitial infiltrate on chest radiograph | ||
* Increased uptake on | * Increased uptake on gallium scan | ||
----- | ----- | ||
| Line 53: | Line 60: | ||
* Dry cough | * Dry cough | ||
* Pleuritic chest pain | * Pleuritic chest pain | ||
* Bronchial breath sounds | |||
* Inflammed, opaque, hypomobile tympanic membrane | * Inflammed, opaque, hypomobile tympanic membrane | ||
=====Laboratory abnormalities===== | =====Laboratory abnormalities===== | ||
* Lymphocytosis | * Lymphocytosis | ||
* Cold agglutinins positive | * Cold agglutinins positive | ||
=====Radiographic features===== | |||
* Alveolar consolidation on chest radiograph | * Alveolar consolidation on chest radiograph | ||
* Interstitial infiltrate on chest radiograph | * Interstitial infiltrate on chest radiograph | ||
| Line 68: | Line 77: | ||
=====Clinical manifestations===== | =====Clinical manifestations===== | ||
* High grade fever | |||
* Hemoptysis | * Hemoptysis | ||
* Fine rales | * Fine rales | ||
| Line 80: | Line 90: | ||
* Productive cough | * Productive cough | ||
* Egophony | * Egophony | ||
=====Laboratory abnormalities===== | =====Laboratory abnormalities===== | ||
* Gram positive diplococci on sputum Gram stain | |||
* Pleural effusion (exudative) | * Pleural effusion (exudative) | ||
* Respiratory alkalosis | * Respiratory alkalosis | ||
=====Radiographic features===== | |||
* Parenchymal hyperlucency on chest radiograph | * Parenchymal hyperlucency on chest radiograph | ||
* Increased uptake on | * Increased uptake on gallium scan | ||
* Unilateral diaphragm elevation on chest radiograph | * Unilateral diaphragm elevation on chest radiograph | ||
* Alveolar consolidation on chest radiograph | * Alveolar consolidation on chest radiograph | ||
* Lobar consolidation on chest radiograph | * Lobar consolidation on chest radiograph | ||
---- | ---- | ||
| Line 98: | Line 109: | ||
=====Clinical manifestations===== | =====Clinical manifestations===== | ||
* Immunosuppressive state | * Immunosuppressive state | ||
* Subcutaneous emphysema | * Subcutaneous emphysema | ||
* Hacking cough | * Hacking cough | ||
| Line 104: | Line 114: | ||
=====Laboratory abnormalities===== | =====Laboratory abnormalities===== | ||
* Respiratory alkalosis | * Respiratory alkalosis | ||
* Serum beta-D-glucan | * Serum beta-D-glucan elevation | ||
=====Radiographic features===== | |||
* Alveolar consolidation on chest radiograph | * Alveolar consolidation on chest radiograph | ||
* Lobar consolidation on chest radiograph | * Lobar consolidation on chest radiograph | ||
* Interstitial infiltrate on chest radiograph | * Interstitial infiltrate on chest radiograph | ||
* Pneumomediastinum on chest radiograph | |||
---- | ---- | ||
| Line 115: | Line 128: | ||
=====Clinical manifestations===== | =====Clinical manifestations===== | ||
* Calf pain | * Calf pain or swelling | ||
* Decreased pulse pressure | * Decreased pulse pressure | ||
* Dyspnea | * Dyspnea | ||
* Hemoptysis | * Hemoptysis | ||
* Hyperventilation | * Hyperventilation | ||
* Immobility | * Immobility | ||
* Increased pulmonic component of heart sound | * Increased pulmonic component of heart sound | ||
* Pleuritic chest pain | * Pleuritic chest pain | ||
* Prior DVT | * Prior DVT | ||
* Pulmonary hypertension | * Pulmonary hypertension | ||
* Right ventricular heave | * Right ventricular heave | ||
* Right-to-left shunt | |||
* Right-to-left shunt | * Substernal chest pain | ||
* Substernal chest pain | |||
* Tachypnea | * Tachypnea | ||
* Thrombophlebitis | * Thrombophlebitis | ||
* Venous stasis | * Venous stasis | ||
* Bone fracture | |||
=====Laboratory abnormalities===== | =====Laboratory abnormalities===== | ||
* Atrial fibrillation | * D-dimer elevation | ||
* | * Hypocapnia | ||
* Hypoxia | |||
* Pleural effusion (exudative or bloody) | |||
* Atrial fibrillation on ECG | |||
* Right axis deviation on ECG | |||
* Right ventricular overload on ECG | |||
=====Radiographic features===== | |||
* Normal chest radiograph | |||
* Atelectasis on chest radiograph | * Atelectasis on chest radiograph | ||
* Lobar consolidation on chest radiograph | * Lobar consolidation on chest radiograph | ||
* Prominent pulmonary artery on chest radiograph | * Prominent pulmonary artery on chest radiograph | ||
* Hampton's hump on chest radiograph | * Hampton's hump on chest radiograph | ||
* Right ventricular enlargement on echocardiography | * Right ventricular enlargement on echocardiography | ||
* Thrombus on echocardiography | * Thrombus on echocardiography | ||
* Segmental perfusion defect on lung scan | * Segmental perfusion defect on lung scan | ||
* V/Q mismatch on lung scan | * V/Q mismatch on lung scan | ||
---- | ---- | ||
| Line 157: | Line 171: | ||
=====Clinical manifestations===== | =====Clinical manifestations===== | ||
* Pectoriloquy | * Pectoriloquy | ||
* Bronchial breath sounds | * Bronchial breath sounds | ||
* Erythema nodosum | |||
* Erythema nodosum | * Purulent sputum | ||
* Purulent sputum | * Shallow respiration | ||
* Shallow respiration | * Increased tactile fremitus | ||
* Increased tactile fremitus | * Pleuritic chest pain | ||
* Pleuritic chest pain | * Egophony | ||
* Egophony | |||
=====Laboratory abnormalities===== | =====Laboratory abnormalities===== | ||
* Gram-positive cocci in chains on sputum Gram stain | * Gram-positive cocci in chains on sputum Gram stain | ||
* Respiratory alkalosis | |||
* Pleural effusion (exudative) | |||
=====Radiographic features===== | |||
* Alveolar consolidation on chest radiograph | * Alveolar consolidation on chest radiograph | ||
* Lobar consolidation on chest radiograph | * Lobar consolidation on chest radiograph | ||
* Empyema on chest radiograph | |||
* Increased uptake on gallium scan | |||
---- | ---- | ||
| Line 181: | Line 197: | ||
=====Clinical manifestations===== | =====Clinical manifestations===== | ||
* Pleuritic chest pain | * Pleuritic chest pain | ||
* Bronchial breath sounds | * Bronchial breath sounds | ||
* | * Recent influenza | ||
* Fine rales | * Fine rales | ||
* Bronchovesicular breath sounds | * Bronchovesicular breath sounds | ||
=====Laboratory abnormalities===== | =====Laboratory abnormalities===== | ||
* Lymphocytosis | * Lymphocytosis | ||
* Respiratory alkalosis | * Respiratory alkalosis | ||
=====Radiographic features===== | |||
* Lobar consolidation on chest radiograph | * Lobar consolidation on chest radiograph | ||
* Interstitial infiltrate on chest radiograph | * Interstitial infiltrate on chest radiograph | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
| Line 198: | Line 217: | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Bacterial diseases]] | [[Category:Bacterial diseases]] | ||
Revision as of 16:55, 9 August 2015
|
Legionellosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Legionellosis differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Legionellosis differential diagnosis |
|
Risk calculators and risk factors for Legionellosis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.
Overview
Legionellosis must be differentiated from other causes of fever, dyspnea, cough, and sputum production, such as bacterial pnuemonia, viral pneumonia, and other causes of atypical pnuemonia.
Differential Diagnosis
The following conditions must be considered in the differential diagnosis of Legionnaires' disease:
DDx [1][2][3][4][5][6][7]- Acute interstitial pneumonia
DDx - Mycoplasma pneumonia
DDx - Pneumococcal pneumonia
DDx - Pneumocystis carinii pneumonia
DDx - Pulmonary embolism
DDx - Streptococcal pneumonia
DDx - Viral pneumonia
DDx
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Mahshid Mir, M.D. [3]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Adult respiratory distress syndrome
- Bronchial breath sounds
- Dry cough
- High grade fever
- Progressive dyspnea
Laboratory abnormalities
- Legionella urinary antigen positive
- Leukocytosis with relative lymphopenia
- Hyponatremia
- Hypophosphatemia
Radiographic features
- Alveolar consolidation on chest radiograph
- Lobar consolidation on chest radiograph
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4] Mahshid Mir, M.D. [5]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Dry cough
- Progressive dyspnea
Laboratory abnormalities
- Nonspecific
Radiographic features
- Disseminated consolidation on chest radiograph
- Interstitial infiltrate on chest radiograph
- Increased uptake on gallium scan
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [6] Mahshid Mir, M.D. [7]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Dry cough
- Pleuritic chest pain
- Bronchial breath sounds
- Inflammed, opaque, hypomobile tympanic membrane
Laboratory abnormalities
- Lymphocytosis
- Cold agglutinins positive
Radiographic features
- Alveolar consolidation on chest radiograph
- Interstitial infiltrate on chest radiograph
- Lobar consolidation on chest radiograph
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [8] Mahshid Mir, M.D. [9]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- High grade fever
- Hemoptysis
- Fine rales
- Pleuritic chest pain
- Increased breath sounds
- Bronchial breath sounds
- Dullness on chest percussion
- Purulent sputum
- Shallow respiration
- Pectoriloquy
- Increased tactile fremitus
- Productive cough
- Egophony
Laboratory abnormalities
- Gram positive diplococci on sputum Gram stain
- Pleural effusion (exudative)
- Respiratory alkalosis
Radiographic features
- Parenchymal hyperlucency on chest radiograph
- Increased uptake on gallium scan
- Unilateral diaphragm elevation on chest radiograph
- Alveolar consolidation on chest radiograph
- Lobar consolidation on chest radiograph
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [10] Mahshid Mir, M.D. [11]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Immunosuppressive state
- Subcutaneous emphysema
- Hacking cough
- Progressive dyspnea
Laboratory abnormalities
- Respiratory alkalosis
- Serum beta-D-glucan elevation
Radiographic features
- Alveolar consolidation on chest radiograph
- Lobar consolidation on chest radiograph
- Interstitial infiltrate on chest radiograph
- Pneumomediastinum on chest radiograph
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [12] Mahshid Mir, M.D. [13]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Calf pain or swelling
- Decreased pulse pressure
- Dyspnea
- Hemoptysis
- Hyperventilation
- Immobility
- Increased pulmonic component of heart sound
- Pleuritic chest pain
- Prior DVT
- Pulmonary hypertension
- Right ventricular heave
- Right-to-left shunt
- Substernal chest pain
- Tachypnea
- Thrombophlebitis
- Venous stasis
- Bone fracture
Laboratory abnormalities
- D-dimer elevation
- Hypocapnia
- Hypoxia
- Pleural effusion (exudative or bloody)
- Atrial fibrillation on ECG
- Right axis deviation on ECG
- Right ventricular overload on ECG
Radiographic features
- Normal chest radiograph
- Atelectasis on chest radiograph
- Lobar consolidation on chest radiograph
- Prominent pulmonary artery on chest radiograph
- Hampton's hump on chest radiograph
- Right ventricular enlargement on echocardiography
- Thrombus on echocardiography
- Segmental perfusion defect on lung scan
- V/Q mismatch on lung scan
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [14] Mahshid Mir, M.D. [15]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Pectoriloquy
- Bronchial breath sounds
- Erythema nodosum
- Purulent sputum
- Shallow respiration
- Increased tactile fremitus
- Pleuritic chest pain
- Egophony
Laboratory abnormalities
- Gram-positive cocci in chains on sputum Gram stain
- Respiratory alkalosis
- Pleural effusion (exudative)
Radiographic features
- Alveolar consolidation on chest radiograph
- Lobar consolidation on chest radiograph
- Empyema on chest radiograph
- Increased uptake on gallium scan
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [16] Mahshid Mir, M.D. [17]
| Differential Diagnosis | |
|---|---|
| DDx Alphabetic Order | |
| A | B |
| C | D |
| E | F |
| G | H |
| I | J |
| K | L |
| M | N |
| O | P |
| Q | R |
| S | T |
| U | V |
| W | X |
| Y | Z |
Clinical manifestations
- Pleuritic chest pain
- Bronchial breath sounds
- Recent influenza
- Fine rales
- Bronchovesicular breath sounds
Laboratory abnormalities
- Lymphocytosis
- Respiratory alkalosis
Radiographic features
- Lobar consolidation on chest radiograph
- Interstitial infiltrate on chest radiograph
References
- ↑ Ferri, Fred (2011). Ferri's differential diagnosis: a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323076999.
- ↑ Siegenthaler, Walter (2007). Differential diagnosis in internal medicine: from symptom to diagnosis. Stuttgart New York: Thieme. ISBN 978-1588905512.
- ↑ Mesko, Dusan (2002). Differential diagnosis by laboratory medicine: a quick reference for physicians. Berlin New York: Springer-Verlag. ISBN 978-3540430575.
- ↑ Reeder and Felson's gamuts in radiology: comprehensive lists of roentgen differential diagnosis. Place of publication not identified: Springer. 2014. ISBN 978-1475781229.
- ↑ Burgener, Francis (2008). Differential diagnosis in conventional radiology. Stuttgart New York: Thieme. ISBN 978-1588902757.
- ↑ Gattuso, Paolo (2015). Differential diagnosis in surgical pathology. Philadelphia, PA: Saunders/Elsevier. ISBN 978-1455770137.
- ↑ "DXplain".