Legionellosis differential diagnosis

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

Overview

Legionnaires' disease 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 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.[1]

Disease Clinical manifestation Lab findings Imaging findings Chest X-ray
Legionnaires' disease [2] [3] [4]
Chest X-ray of a patient with Legionnaires disease courtesy Hellerhoff
Q fever [5] [6]

multiple soft infiltrative shadows on CXR

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
Acute interstitial pneumonia
  • Nonspecific
Acute Interstitial Pneumonitis Chest X-ray - Case Courtesy of Dr Salam, Radiopaedia, rID 45404
Pneumococcal pneumonia
Chest X-ray of a patient with pneumococcal pneumonia - case courtesy Dr Jack Ren,  Radiopaedia.org, rID 29090
Pneumocystis carinii pneumonia
Pneumocystis Jiroverci Chest Xray - Case Courtesy of Dr Behrang Amini, Radiopaedia, rID 1901
Pulmonary embolism
Hampton Hump in a patient with pulmonary embolism courtesy of Hellerhoff
Viral pneumonia


References

  1. 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.
  2. Cunha BA, Burillo A, Bouza E (2016). "Legionnaires' disease". Lancet. 387 (10016): 376–385. doi:10.1016/S0140-6736(15)60078-2. PMID 26231463.
  3. Cunha BA, Cunha CB (2017). "Legionnaire's Disease: A Clinical Diagnostic Approach". Infect Dis Clin North Am. 31 (1): 81–93. doi:10.1016/j.idc.2016.10.007. PMID 28159178.
  4. Chahin A, Opal SM (2017). "Severe Pneumonia Caused by Legionella pneumophila: Differential Diagnosis and Therapeutic Considerations". Infect Dis Clin North Am. 31 (1): 111–121. doi:10.1016/j.idc.2016.10.009. PMC 7135102 Check |pmc= value (help). PMID 28159171.
  5. Okimoto N, Asaoka N, Osaki K, Kurihara T, Yamato K, Sunagawa T; et al. (2004). "Clinical features of Q fever pneumonia". Respirology. 9 (2): 278–82. doi:10.1111/j.1440-1843.2004.00586.x. PMID 15182283.
  6. Caron F, Meurice JC, Ingrand P, Bourgoin A, Masson P, Roblot P; et al. (1998). "Acute Q fever pneumonia: a review of 80 hospitalized patients". Chest. 114 (3): 808–13. doi:10.1378/chest.114.3.808. PMID 9743171.