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| Line 7: |
Line 7: |
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| ==Differential Diagnosis== | | ==Differential Diagnosis== |
| {{ddx0|Legionnaires' disease}}{{ddx1|[[Acute interstitial pneumonia]]}}
| | * Legionnaires' disease |
| {{ddx1|[[Mycoplasma pneumonia]]}}
| | * Mycoplasma pneumonia |
| {{ddx1|Pneumococcal [[pneumonia]]}}
| | * Pneumococcal pneumonia |
| {{ddx1|Pneumocystis carinii [[pneumonia]]}}
| | * Pneumocystis carinii pneumonia |
| {{ddx1|[[Pulmonary embolism]]}}
| | * Pulmonary embolism |
| {{ddx1|Streptococcal [[pneumonia]]}}
| | * Streptococcal pneumonia |
| {{ddx1|Viral [[pneumonia]]}}
| | * Viral pneumonia |
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| ----
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| {{ddx|Legionnaires' disease}}
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| =====Clinical manifestations=====
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| * [[Adult respiratory distress syndrome]]
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| * [[Breath sounds|Bronchial breath sounds]]
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| * [[Dry cough]]
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| * [[Fever|High grade fever]]
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| * [[Dyspnea|Progressive dyspnea]]
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|
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| =====Laboratory abnormalities=====
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| * Legionella urinary antigen positive
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| * [[Leukocytosis]] with relative [[lymphopenia]]
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| * [[Hyponatremia]]
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| * [[Hypophosphatemia]]
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| =====Radiographic features=====
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| * [[Alveoli|Alveolar consolidation]] on chest radiograph
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| * [[Consolidation (medicine)|Lobar consolidation]] on chest radiograph
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| ----
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| {{ddx|Acute interstitial pneumonia}}
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|
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| =====Clinical manifestations=====
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| * [[Dry cough]]
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| * [[Dyspnea|Progressive dyspnea]]
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| =====Laboratory abnormalities=====
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| * Nonspecific
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| =====Radiographic features=====
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| * Disseminated [[Consolidation (medicine)|consolidation]] on [[chest radiograph]]
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| * Interstitial infiltrate on chest radiograph
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| * Increased uptake on gallium scan
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| -----
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| {{ddx|Mycoplasma pneumonia}}
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|
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| =====Clinical manifestations=====
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| * [[Dry cough]]
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| * [[Pleuritic chest pain]]
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| * Bronchial [[breath sounds]]
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| * [[Inflamed]], opaque, hypomobile [[tympanic membrane]]
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| =====Laboratory abnormalities=====
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| * [[Lymphocytosis]]
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| * [[Cold agglutinins]] positive
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|
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| =====Radiographic features=====
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| * [[Alveolar]] [[Consolidation (medicine)|consolidation]] on [[chest radiograph]]
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| * Interstitial infiltrate on [[chest radiograph]]
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| * Lobar [[Consolidation (medicine)|consolidation]] on [[chest radiograph]]
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|
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| ----
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| {{ddx|Pneumococcal pneumonia}}
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|
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| =====Clinical manifestations=====
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| * [[Fever|High grade fever]]
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| * [[Hemoptysis]]
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| * [[Rales|Fine rales]]
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| * [[Pleuritic chest pain]]
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| * Increased [[breath sounds]]
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| * Bronchial b[[Breath sounds|reath sounds]]
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| * Dullness on chest percussion
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| * [[Sputum|Purulent sputum]]
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| * [[Shallow respiration]]
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| * Pectoriloquy
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| * Increased [[tactile fremitus]]
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| * [[Productive cough]]
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| * [[Egophony]]
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| =====Laboratory abnormalities=====
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| * [[Gram positive bacteria|Gram positive]] [[diplococci]] on sputum Gram stain
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| * [[Pleural effusion]] ([[exudative]])
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| * Respiratory alkalosis
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| =====Radiographic features=====
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| * Parenchymal hyperlucency on [[chest radiograph]]
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| * Increased uptake on [[gallium scan]]
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| * Unilateral diaphragm elevation on [[chest radiograph]]
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| * Alveolar [[Consolidation (medicine)|consolidation]] on [[chest radiograph]]
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| * Lobar [[Consolidation (medicine)|consolidation]] on [[chest radiograph]]
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| ----
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| {{ddx|Pneumocystis carinii pneumonia}}
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|
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| =====Clinical manifestations=====
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| * [[Immunosuppressive]] state
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| * [[Subcutaneous emphysema]]
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| * [[Cough|Hacking cough]]
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| * [[Dyspnea|Progressive dyspnea]]
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| =====Laboratory abnormalities=====
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| * [[Respiratory alkalosis]]
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| * Serum beta-D-glucan elevation
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|
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| =====Radiographic features=====
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| * [[Alveolar]] [[Consolidation (medicine)|consolidation]] on [[chest radiograph]]
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| * Lobar [[Consolidation (medicine)|consolidation]] on [[chest radiograph]]
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| * Interstitial infiltrate on [[chest radiograph]]
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| * [[Pneumomediastinum]] on [[chest radiograph]]
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| ----
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| {{ddx|Pulmonary embolism}}
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|
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| =====Clinical manifestations=====
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| * Calf [[pain]] or [[swelling]]
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| * Decreased [[pulse pressure]]
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| * [[Dyspnea]]
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| * [[Hemoptysis]]
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| * [[Hyperventilation]]
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| * [[Immobility]]
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| * Increased pulmonic component of heart sound
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| * [[Pleuritic chest pain]]
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| * Prior [[Deep vein thrombosis|DVT]]
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| * [[Pulmonary hypertension]]
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| * Right ventricular heave
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| * [[Right-to-left shunt]]
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| * [[Substernal chest pain]]
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| * [[Tachypnea]]
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| * [[Thrombophlebitis]]
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| * [[Venous stasis]]
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| * [[Bone fracture]]
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|
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| =====Laboratory abnormalities=====
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| * [[D-dimer]] elevation
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| * [[Hypocapnia]]
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| * [[Hypoxia]]
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| * [[Pleural effusion]] (exudative or bloody)
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| * [[Atrial fibrillation]] on ECG
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| * [[Right axis deviation]] on ECG
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| * Right ventricular overload on ECG
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|
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| =====Radiographic features=====
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| * Normal [[chest radiograph]]
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| * [[Atelectasis]] on [[chest radiograph]]
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| * Lobar consolidation on [[chest radiograph]]
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| * Prominent [[pulmonary artery]] on [[chest radiograph]]
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| * [[Hampton's hump]] on [[chest radiograph]]
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| * Right ventricular enlargement on [[echocardiography]]
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| * [[Thrombus]] on echocardiography
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| * Segmental [[perfusion]] defect on lung scan
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| * [[V/Q scan|V/Q]] mismatch on lung scan
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| ----
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| {{ddx|Streptococcal pneumonia}}
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|
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| =====Clinical manifestations=====
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| * Pectoriloquy
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| * Bronchial [[breath sounds]]
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| * [[Erythema nodosum]]
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| * Purulent [[sputum]]
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| * [[Shallow respiration]]
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| * Increased [[tactile fremitus]]
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| * [[Pleuritic chest pain]]
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| * [[Egophony]]
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|
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| =====Laboratory abnormalities=====
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| * [[Gram-positive cocci]] in chains on sputum [[Gram stain]]
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| * [[Respiratory alkalosis]]
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| * [[Pleural effusion]] (exudative)
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|
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| =====Radiographic features=====
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| * Alveolar consolidation on chest radiograph
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| * Lobar consolidation on chest radiograph
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| * [[Empyema]] on chest radiograph
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| * Increased uptake on [[gallium scan]]
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|
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| ----
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|
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| {{ddx|Viral pneumonia}}
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|
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| =====Clinical manifestations=====
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| * [[Pleuritic chest pain]]
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| * [[Breath sounds|Bronchial breath sounds]]
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| * Recent [[influenza]]
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| * Fine [[rales]]
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| * [[Breath sounds|Bronchovesicular breath sounds]]
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|
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| =====Laboratory abnormalities=====
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| * [[Lymphocytosis]]
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| * [[Respiratory alkalosis]]
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|
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| =====Radiographic features=====
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| * Lobar [[Consolidation (medicine)|consolidation]] on [[chest radiograph]]
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| * Interstitial infiltrate on [[chest radiograph]]
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| ==Differentiating legionellosis from other causes of atypical pneumonia== | | ==Differentiating legionellosis from other causes of atypical pneumonia== |
