Legionellosis differential diagnosis: Difference between revisions

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!Lab findings
!Lab findings
!Chest X-ray
!Chest X-ray
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|[[Legionellosis]]
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* [[Legionellosis]] is characterized by cough that is slightly productive.<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref>
* Constitutional symptoms such as [[chills]], [[myalgia]], and [[arthralgia]].
* Gastrointestinal symptoms such as [[diarrhea]], [[nausea]], and [[vomiting]].
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* Labs are nonspecific for diagnosing [[legionellosis]]
* [[Renal dysfunction|Renal]] and [[hepatic dysfunction]]
* [[Thrombocytopenia]] and [[leukocytosis]]
* [[Hyponatremia]]
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[[Image:Legionella-pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816.jpg|center|300px|thumb|Legionella pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816 ]]
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|Q fever
|Q fever
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[[Image:Atypical-pneumonia-mycoplasma - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781.jpg|center|300px|thumb|Mycoplasma pneumonia - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781]]
[[Image:Atypical-pneumonia-mycoplasma - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781.jpg|center|300px|thumb|Mycoplasma pneumonia - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781]]
|-
|[[Legionellosis]]
|
* [[Legionellosis]] is characterized by cough that is slightly productive.<ref name="pmid23422417">{{cite journal |vauthors=Irfan M, Farooqi J, Hasan R |title=Community-acquired pneumonia |journal=Curr Opin Pulm Med |volume=19 |issue=3 |pages=198–208 |year=2013 |pmid=23422417 |doi=10.1097/MCP.0b013e32835f1d12 |url=}}</ref>
* Constitutional symptoms such as [[chills]], [[myalgia]], and [[arthralgia]].
* Gastrointestinal symptoms such as [[diarrhea]], [[nausea]], and [[vomiting]].
|
* Labs are nonspecific for diagnosing [[legionellosis]]
* [[Renal dysfunction|Renal]] and [[hepatic dysfunction]]
* [[Thrombocytopenia]] and [[leukocytosis]]
* [[Hyponatremia]]
|
[[Image:Legionella-pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816.jpg|center|300px|thumb|Legionella pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816 ]]
|-
|-
|[[Chlamydia pneumonia]]
|[[Chlamydia pneumonia]]

Revision as of 17:55, 2 November 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Legionellosis must be differentiated from other causes of fever, dyspnea, cough, and sputum production, such as bacterial pneumonia, viral pneumonia, and other causes of atypical pneumonia.

Differential Diagnosis

  • Legionnaires' disease
  • Mycoplasma pneumonia
  • Pneumococcal pneumonia
  • Pneumocystis carinii pneumonia
  • Pulmonary embolism
  • Streptococcal pneumonia
  • Viral pneumonia


Differentiating legionellosis from other causes of atypical pneumonia

Legionellosis must be differentiated from other diseases that cause atypical pneumonia such as Q fever and mycoplasma pneumonia

Disease Prominent clinical features Lab findings Chest X-ray
Legionellosis
Legionella pneumonia - Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID 31816
Q fever
  • Antibody detection using indirect immunofluorescence (IIF) is the preferred method for diagnosis.
  • PCR can be used if IIF is negative, or very early once disease is suspected.
  • C. burnetii does not grow on ordinary blood cultures, but can be cultivated on special media such as embryonated eggs or cell culture.
  • A two-to-three fold increase in AST and ALT is seen in most patients.
Q fever pneumonia - - Case courtesy of Royal Melbourne Hospital Respiratory, Radiopaedia.org, rID 21993
Mycoplasma pneumonia
Mycoplasma pneumonia - Case courtesy of Dr Alborz Jahangiri, Radiopaedia.org, rID 45781
Chlamydia pneumonia
Chlamydia-pneumonia - Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID 14567

References

  1. 1.0 1.1 1.2 1.3 Irfan M, Farooqi J, Hasan R (2013). "Community-acquired pneumonia". Curr Opin Pulm Med. 19 (3): 198–208. doi:10.1097/MCP.0b013e32835f1d12. PMID 23422417.