Multi-drug-resistant tuberculosis differential diagnosis
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Differentiating Multi-drug-resistant tuberculosis from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
Pulmonary tuberculosis must be differentiated from other diseases that cause cough, fever, night sweats, hemoptysis and weight loss, such as: brucellosis, bronchogenic carcinoma, Hodgkin lymphoma, bacterial pneumonia, sarcoidosis, mycoplasmal pneumonia.
Differential Diagnosis
Pulmonary Tuberculosis
| Disease | Findings |
|---|---|
| Bacterial pneumonia | Sudden onset of symptoms, such as high fever, cough, purulent sputum, chest pain. Consolidation on chest X-ray, leukocytosis. |
| Bronchogenic carcinoma | Can be asymptomatic, usually at older ages (> 50 years old); Symptoms include cough, hemoptysis, weight loss |
| Brucellosis | Fever, anorexia, night sweats, malaise,back pain , headache, and depression. History of exposure to infected animal |
| Hodgkin lymphoma | Fever, night sweats, pruritus, painless adenopathy, mediastinal mass |
| Mycoplasmal pneumonia | Gradual onset of dry cough, headache, malaise, sore throat. Diffuse bilateral infiltrates in chest X-ray. |
| Sarcoidosis | Non-caseating granulomas in lungs and other organs, bilateral hiliar adenopathy, predominantly in African American females. |
| Adapted from Mandell, Douglas, and Bennett's principles and practice of infectious diseases 2010 [1] | |
Extra-Pulmonary Tuberculosis
| Extra-Pulmonary Location | Differential Diagnosis |
|---|---|
| Tuberculous Lymphadenitis | Lymphoma, squamous cell carcinoma, papillary thyroid cancer, pyogenic infection |
| Skeletal Tuberculosis | Multiple myeloma, bone metastasis, spinal cord abscess, osteoporosis |
| Tuberculous Arthrits | Bacterial septic arthritis, pseudogout |
| Central Nervous System Tuberculosis | Bacterial meningitis, viral meningitis, encephalitis |
| Tuberculosis Peritonitis | Bacterial peritonitis, chronic peritoneal dialysis |
| Adapted from Asian Spine J. Feb 2014; 8(1): 97–111[2]; Handbook of Clinical Neurology[3]; Circulation Dec 2005 vol.112 no.23 3608-3616[4]; Am J Trop Med Hyg 2013 vol. 88 no. 1 54-64[5] Clin Infect Dis.(2011)53(6):555-562.[6] | |
References
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Moon, Myung-Sang (2014). "Tuberculosis of Spine: Current Views in Diagnosis and Management". Asian Spine Journal. 8 (1): 97. doi:10.4184/asj.2014.8.1.97. ISSN 1976-1902.
- ↑ Garcia-Monco, Juan Carlos (2014). "Tuberculosis". 121: 1485–1499. doi:10.1016/B978-0-7020-4088-7.00100-0. ISSN 0072-9752.
- ↑ Mayosi, B. M. (2005). "Tuberculous Pericarditis". Circulation. 112 (23): 3608–3616. doi:10.1161/CIRCULATIONAHA.105.543066. ISSN 0009-7322.
- ↑ Daher, E. D. F.; da Silva Junior, G. B.; Barros, E. J. G. (2013). "Renal Tuberculosis in the Modern Era". American Journal of Tropical Medicine and Hygiene. 88 (1): 54–64. doi:10.4269/ajtmh.2013.12-0413. ISSN 0002-9637.
- ↑ Fontanilla, J.-M.; Barnes, A.; von Reyn, C. F. (2011). "Current Diagnosis and Management of Peripheral Tuberculous Lymphadenitis". Clinical Infectious Diseases. 53 (6): 555–562. doi:10.1093/cid/cir454. ISSN 1058-4838.