Aspiration pneumonia differential diagnosis: Difference between revisions
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==Aspiration pneumonia differential diagnosis== | ==Aspiration pneumonia differential diagnosis== | ||
Aspiration pneumonia must be differentiated from other diseases that cause [[cough]] and [[dyspnea]]. | Aspiration pneumonia must be differentiated from other diseases that cause [[productive cough]], [[fever]], and [[dyspnea]]. | ||
{| | {| | ||
! colspan="2" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Organ system | ! colspan="2" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Organ system | ||
Line 28: | Line 28: | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |[[Respiratory system|'''Respiratory''']] | | rowspan="5" align="center" style="background:#DCDCDC;" + |[[Respiratory system|'''Respiratory''']] | ||
| align="center" style="background:#DCDCDC;" + |[[Upper respiratory tract|'''Upper airway diseases''']] | | rowspan="5" align="center" style="background:#DCDCDC;" + |[[Upper respiratory tract|'''Upper airway diseases''']] | ||
| align="center" style="background:#DCDCDC;" + |[[Croup|'''Croup''']]<ref name="Cherry2008">{{cite journal|last1=Cherry|first1=James D.|title=Croup|journal=New England Journal of Medicine|volume=358|issue=4|year=2008|pages=384–391|issn=0028-4793|doi=10.1056/NEJMcp072022}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Acute | |||
| style="background:#F5F5F5;" + | | |||
*3−5 days | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Stridor]] | |||
*[[Rales|Crackles]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Leukopenia]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Respiratory system|Subglottic]] narrowing ([[steeple sign]]) in postero−anterior [[Radiography|radiograph]] chest | |||
| style="background:#F5F5F5;" + | | |||
*Decresed [[Lung volumes|tidal volume]] | |||
| style="background:#F5F5F5;" + | | |||
*Clinical diagnosis. | |||
*Laboratory findings and imaging are not necessary for diagnosis | |||
| style="background:#F5F5F5;" + | | |||
*[[Barking cough]] | |||
*Etiology: [[Human parainfluenza viruses|''Parainfluenza'' virus type 1]] (most common) | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |[[Pertussis|'''Pertussis''']]<ref name="pmid3816065">{{cite journal |vauthors=Bellamy EA, Johnston ID, Wilson AG |title=The chest radiograph in whooping cough |journal=Clin Radiol |volume=38 |issue=1 |pages=39–43 |year=1987 |pmid=3816065 |doi= |url=}}</ref><ref name="urlPertussis | Whooping Cough | Clinical | Information | CDC">{{cite web |url=https://www.cdc.gov/pertussis/clinical/index.html |title=Pertussis | Whooping Cough | Clinical | Information | CDC |format= |work= |accessdate=}}</ref> | | align="center" style="background:#DCDCDC;" + |[[Pertussis|'''Pertussis''']]<ref name="pmid3816065">{{cite journal |vauthors=Bellamy EA, Johnston ID, Wilson AG |title=The chest radiograph in whooping cough |journal=Clin Radiol |volume=38 |issue=1 |pages=39–43 |year=1987 |pmid=3816065 |doi= |url=}}</ref><ref name="urlPertussis | Whooping Cough | Clinical | Information | CDC">{{cite web |url=https://www.cdc.gov/pertussis/clinical/index.html |title=Pertussis | Whooping Cough | Clinical | Information | CDC |format= |work= |accessdate=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Acute | | align="center" style="background:#F5F5F5;" + |Acute | ||
Line 55: | Line 80: | ||
*Phases: Catarrhal, paroxysmal and convalescent | *Phases: Catarrhal, paroxysmal and convalescent | ||
|- | |- | ||
| | | align="center" style="background:#DCDCDC;" + |'''[[Laryngopharyngeal reflux disease|Laryngopharyngeal reflux]]'''<ref name="urlWhat is LPR? | American Academy of Otolaryngology-Head and Neck Surgery">{{cite web |url=http://www.entnet.org/content/what-lpr |title=What is LPR? | American Academy of Otolaryngology-Head and Neck Surgery |format= |work= |accessdate=}}</ref><ref name="pmid12461340">{{cite journal |vauthors=Noordzij JP, Khidr A, Desper E, Meek RB, Reibel JF, Levine PA |title=Correlation of pH probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis |journal=Laryngoscope |volume=112 |issue=12 |pages=2192–5 |year=2002 |pmid=12461340 |doi=10.1097/00005537-200212000-00013 |url=}}</ref> | ||
| | | align="center" style="background:#F5F5F5;" + |Chronic | ||
| align="center" style="background:#DCDCDC;" + |[[ | | style="background:#F5F5F5;" + | | ||
| align="center" style="background:#F5F5F5;" + | | *Variable | ||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Hoarseness]] | |||
*[[Stridor]] | |||
| style="background:#F5F5F5;" + | | |||
*Decreased levels of salivary [[epidermal growth factor]] ([[EGF module-containing mucin-like hormone receptor|EGF]]) | |||
*Increased levels of [[NKTR]] | |||
*[[Biopsy]] may be helpful | |||
| style="background:#F5F5F5;" + | | |||
*[[X-rays|X−Ray]] may be helpful | |||
*[[Endoscopy]] examination may be helpful as well | |||
| style="background:#F5F5F5;" + | | |||
*Normal function | |||
| style="background:#F5F5F5;" + | | |||
*24 hour−dual sensor [[pH]] probe | |||
| style="background:#F5F5F5;" + | | |||
*Throat clearing | |||
*[[Globus pharyngis|Globus sensation]] | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |'''[[Common Cold Unit|Common Cold]]'''<ref name="pmid16253889">{{cite journal |vauthors=Eccles R |title=Understanding the symptoms of the common cold and influenza |journal=Lancet Infect Dis |volume=5 |issue=11 |pages=718–25 |year=2005 |pmid=16253889 |doi=10.1016/S1473-3099(05)70270-X |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Acute | |||
| style="background:#F5F5F5;" + | | |||
*3−10 days | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| style="background:#F5F5F5;" + | | |||
*[[Rales]] | |||
*[[Wheeze|Wheezing]] | |||
| style="background:#F5F5F5;" + | | |||
*Bacterial culture is not indicated | |||
| style="background:#F5F5F5;" + | | |||
*[[Chest X-ray|Chest X−Ray]] in patients with signs of [[consolidation]] | |||
| style="background:#F5F5F5;" + | | |||
*Normal function | |||
| style="background:#F5F5F5;" + | | |||
*Clinical diagnosis | |||
| style="background:#F5F5F5;" + | | |||
*[[Conjunctival injection]] | |||
*[[Nasal congestion]] | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |[[Rhinosinusitis|'''Rhinosinusitis''']]<ref name="pmid21490181">{{cite journal| author=Meltzer EO, Hamilos DL| title=Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines. | journal=Mayo Clin Proc | year= 2011 | volume= 86 | issue= 5 | pages= 427-43 | pmid=21490181 | doi=10.4065/mcp.2010.0392 | pmc=3084646 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21490181 }}</ref><ref name="pmid25832968">{{cite journal |vauthors=Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD |title=Clinical practice guideline (update): adult sinusitis |journal=Otolaryngol Head Neck Surg |volume=152 |issue=2 Suppl |pages=S1–S39 |year=2015 |pmid=25832968 |doi=10.1177/0194599815572097 |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |[[Acute (medicine)|Acute]], [[subacute]], [[chronic]], recurrent | |||
| style="background:#F5F5F5;" + | | |||
*[[Acute (medicine)|Acute]]: Less than 4 weeks | |||
*[[Subacute]]: 4−12 weeks | |||
*[[Chronic (medical)|Chronic]]: More than 12 weeks | |||
*Recurrent: 4 or more episodes or acute rhinosinusitis per year | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*Clear chest | |||
| style="background:#F5F5F5;" + | | |||
*In complicated acute [[Rhinosinusitis|bacterial rhinosinusitis]], endoscopic cultures or [[sinus]] aspirate is indicated | |||
*Nasal culture may also be helpful | |||
| style="background:#F5F5F5;" + | | |||
*Air−fluid level, mucosal [[edema]] and bony erosion of sinus on [[Computed tomography|CT]] | |||
*[[Magnetic resonance imaging|MRI]] for distinguish the [[etiology]] | |||
| style="background:#F5F5F5;" + | | |||
*Normal function | |||
| style="background:#F5F5F5;" + | | |||
*Clinical diagnosis: [[Nasal congestion]], [[obstruction]], and purulent [[rhinorrhea]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Erythema]] in [[Periorbital edema|periorbital]] area | |||
|- | |||
! colspan="2" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Organ system | |||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases | |||
! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestations | |||
! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diagnosis | |||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Other features | |||
|- | |||
! colspan="7" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Physical exam | |||
|- | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Onset | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Duration | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Productive cough | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hemoptysis | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Weight lost | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ascultation | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Lab findings | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Imaging | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |PFT | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | |||
|- | |||
| rowspan="8" align="center" style="background:#DCDCDC;" + |[[Respiratory system|'''Respiratory''']] | |||
| rowspan="8" align="center" style="background:#DCDCDC;" + |[[Lower respiratory tract|'''Lower airway''']] | |||
| align="center" style="background:#DCDCDC;" + |[[Asthma|'''Asthma''']]<ref name="pmid19626179">{{cite journal| author=Ukena D, Fishman L, Niebling WB| title=Bronchial asthma: diagnosis and long-term treatment in adults. | journal=Dtsch Arztebl Int | year= 2008 | volume= 105 | issue= 21 | pages= 385-94 | pmid=19626179 | doi=10.3238/arztebl.2008.0385 | pmc=2696883 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19626179 }}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Chronic | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*Years | *Years | ||
| align="center" style="background:#F5F5F5;" + | + Clear [[Mucoid plaque|mucoid]] or yellow [[sputum]] | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Wheeze|Wheezing]] (expiratory) | |||
*[[Rales]] | |||
*[[Rhonchi]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Eosinophilia]] | |||
*Total [[serum]] [[Immunoglobulin E|IgE]] in test for [[allergy]] may be helpful | |||
| style="background:#F5F5F5;" + | | |||
*Normal [[Airway|airways]] in [[Chest X-ray|chest X−ray]] | |||
*[[Computed tomography|CT]] if there any abnormality in [[Chest X-Ray|chest X−Ray]] | |||
| style="background:#F5F5F5;" + | | |||
*[[FEV1/FVC ratio]] <70% and [[FEV1]] >15% increase after 15 minutes of 2 puffs of [[Beta-2-adrenoreceptor agonists|beta 2 sympathomimetic drug]] | |||
*After physical active [[FEV1]] decreases by >15% | |||
*After inhaled [[corticosteroid]] (ICS)[[FEV1]] increased by >15% | |||
| style="background:#F5F5F5;" + | | |||
*Airflow limitation on [[spirometry]] | |||
| style="background:#F5F5F5;" + | | |||
*Family history | |||
*Seasonal variation | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |'''[[Chronic obstructive pulmonary disease|Acute Bronchitis]]'''<ref name="pmid17108344">{{cite journal |vauthors=Wenzel RP, Fowler AA |title=Clinical practice. Acute bronchitis |journal=N. Engl. J. Med. |volume=355 |issue=20 |pages=2125–30 |year=2006 |pmid=17108344 |doi=10.1056/NEJMcp061493 |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Acute | |||
| style="background:#F5F5F5;" + | | |||
*From 5 days to 1 or 3 weeks | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | +/− | |||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | |||
*[[Wheezing]] | |||
*[[Rhonchi]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Sputum culture]] is not indicated | |||
*[[Polymerase chain reaction|PCR]] in bacterial infection may be helpful | |||
| style="background:#F5F5F5;" + | | |||
*[[Chest X-ray|Chest X−ray]] to exclude other diseases | |||
| style="background:#F5F5F5;" + | | |||
*FEV1 < 80% | |||
| style="background:#F5F5F5;" + | | |||
*Clinical diagnosis | |||
| style="background:#F5F5F5;" + | | |||
*Majority of cases are caused by [[respiratory]] [[viruses]] | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |[[Chronic bronchitis|'''Chronic Bronchitis''']]<ref name="pmid24692133">{{cite journal |vauthors=Brusasco V, Martinez F |title=Chronic obstructive pulmonary disease |journal=Compr Physiol |volume=4 |issue=1 |pages=1–31 |year=2014 |pmid=24692133 |doi=10.1002/cphy.c110037 |url=}}</ref><ref name="pmid17975186">{{cite journal |vauthors=Qaseem A, Snow V, Shekelle P, Sherif K, Wilt TJ, Weinberger S, Owens DK |title=Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians |journal=Ann. Intern. Med. |volume=147 |issue=9 |pages=633–8 |year=2007 |pmid=17975186 |doi= |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Chronic | |||
| style="background:#F5F5F5;" + | | |||
*Most of the days for three months in the las two years. | |||
| align="center" style="background:#F5F5F5;" + | + Clear [[sputum]] | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
Line 69: | Line 247: | ||
*[[Wheeze|Wheezing]] | *[[Wheeze|Wheezing]] | ||
*[[Rhonchi]] | *[[Rhonchi]] | ||
| style="background:#F5F5F5;" + | | |||
*[[CBC]] and [[ABG]] may be helpful | |||
| style="background:#F5F5F5;" + | | |||
*[[Chest X-ray|Chest X−Ray]] to exclude other diseases | |||
*[[Computed tomography|CT]] may also be helpful | |||
| style="background:#F5F5F5;" + | | |||
*[[FEV1/FVC ratio]] < 70% | |||
*Post bronchodilatador [[FEV1]] > 80% | |||
*Reduced [[Vital capacity|FVC]] after bronchodilatador administration | |||
*Decread [[vital capacity]] | |||
*Increased [[total lung capacity]] | |||
| style="background:#F5F5F5;" + | | |||
*Demostration of airflow limitation on [[spirometry]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Smoker's cough]] | |||
*Cigarette smoking | |||
*Pollution | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |'''Non−asthmatic eosinophilic bronchitis'''<ref name="pmid16428700">{{cite journal |vauthors=Brightling CE |title=Chronic cough due to nonasthmatic eosinophilic bronchitis: ACCP evidence-based clinical practice guidelines |journal=Chest |volume=129 |issue=1 Suppl |pages=116S–121S |year=2006 |pmid=16428700 |doi=10.1378/chest.129.1_suppl.116S |url=}}</ref><ref name="pmid29317659">{{cite journal| author=Cho J, Choi SM, Lee J, Park YS, Lee SM, Yoo CG et al.| title=Clinical Outcome of Eosinophilic Airway Inflammation in Chronic Airway Diseases Including Nonasthmatic Eosinophilic Bronchitis. | journal=Sci Rep | year= 2018 | volume= 8 | issue= 1 | pages= 146 | pmid=29317659 | doi=10.1038/s41598-017-18265-2 | pmc=5760521 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29317659 }}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Chronic | |||
| style="background:#F5F5F5;" + | | |||
*More than 8 weeks | |||
| align="center" style="background:#F5F5F5;" + | + [[Eosinophilic]] [[sputum]] | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Wheeze|Wheezing]] | |||
*[[Shortness of breath]] | |||
| style="background:#F5F5F5;" + | | |||
*High levels of [[Immunoglobulin E|IgE]] | |||
*Airway [[eosinophilia]] in [[sputum]] induction or bronchial wash fluid from [[bronchoscopy]] ([[bronchoalveolar lavage]]) | |||
| style="background:#F5F5F5;" + | | |||
*Normal [[Chest X-Ray|chest X−Ray]] | |||
| style="background:#F5F5F5;" + | | |||
*[[FEV1/FVC ratio|FEV1/FVC]] >70% | |||
*No response of short acting [[bronchodilator]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Bronchial]] [[biopsy]] | |||
*[[Eosinophilia]] | |||
| style="background:#F5F5F5;" + | | |||
*Exposure to an occupational cause | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |[[Bronchiectasis|'''Bronchiectasis''']]<ref name="pmid166509702">{{cite journal |vauthors=King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW |title=Characterisation of the onset and presenting clinical features of adult bronchiectasis |journal=Respir Med |volume=100 |issue=12 |pages=2183–9 |year=2006 |pmid=16650970 |doi=10.1016/j.rmed.2006.03.012 |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Chronic | |||
| style="background:#F5F5F5;" + | | |||
*Months to years | |||
| align="center" style="background:#F5F5F5;" + | + Mucopurulent [[sputum]] | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Rales|Crackles]] | *[[Rales|Crackles]] | ||
*[[Wheeze|Wheezing]] | |||
*[[Shortness of breath]] | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[CBC]] and [[ | *[[Complete blood count]] ([[Complete blood count|CBC]]) | ||
*[[Immunoglobulin G|IgG]], [[Immunoglobulin M|IgM]] and [[Immunoglobulin A|IgA]] | |||
*[[Sputum]] culture for [[Fungus|fungi]], [[bacteria]] and [[Mycobacterium|mycobacteria]] | |||
| style="background:#F5F5F5;" + | | |||
*Linear [[atelectasis]] and dilated [[Airway|airways]] in [[Chest X-Ray|chest X−Ray]] | |||
| style="background:#F5F5F5;" + | | |||
*[[FEV1/FVC ratio|FEV1/FVC]] <70% | |||
*Normal [[Vital capacity|FVC]] | |||
*Low levels of [[Spirometry|FEV1]] | |||
| style="background:#F5F5F5;" a+ | | |||
*[[Computed tomography|CT]] of chest | |||
| style="background:#F5F5F5;" + | | |||
*[[Digital clubbing]] | |||
*Recurrent [[pleurisy]] | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |'''[[Emphysema]]''' <ref name="pmid28919728">{{cite journal| author=Rossi A, Butorac-Petanjek B, Chilosi M, Cosío BG, Flezar M, Koulouris N et al.| title=Chronic obstructive pulmonary disease with mild airflow limitation: current knowledge and proposal for future research - a consensus document from six scientific societies. | journal=Int J Chron Obstruct Pulmon Dis | year= 2017 | volume= 12 | issue= | pages= 2593-2610 | pmid=28919728 | doi=10.2147/COPD.S132236 | pmc=5587130 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28919728 }}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Chronic | |||
| style="background:#F5F5F5;" + | | |||
*Months to years | |||
| align="center" style="background:#F5F5F5;" + | + Mucoid or purulent [[sputum]] | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*Shortness of [[Breathing|breath]] | |||
*[[Wheeze|Wheezing]] | |||
*Prolonged [[Exhalation|expiration]] | |||
*[[Rales|Crackles]] | |||
| style="background:#F5F5F5;" + | | |||
*Testing for [[Alpha 1-antitrypsin|alpha 1−antitrypsin]] may be helpful | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Chest X-ray|Chest X−Ray]] to exclude other diseases | ||
*[[Computed tomography|CT | *[[Computed tomography|CT]] may also be helpful | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[FEV1/FVC ratio|FEV1/FVC]] <70% | *[[FEV1/FVC ratio|FEV1/FVC]] <70% | ||
*[[FEV1]] | *Post [[bronchodilator]] [[FEV1]] >80 | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Detection of early [[emphysema]] in [[Computed tomography|CT]] of chest | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Exposure of tobacco and air pollution | ||
* | |- | ||
* | | align="center" style="background:#DCDCDC;" + |'''Foreing body [[Aspiration of foreign body|aspiration]]'''<ref name="pmid29221325">{{cite journal| author=Hewlett JC, Rickman OB, Lentz RJ, Prakash UB, Maldonado F| title=Foreign body aspiration in adult airways: therapeutic approach. | journal=J Thorac Dis | year= 2017 | volume= 9 | issue= 9 | pages= 3398-3409 | pmid=29221325 | doi=10.21037/jtd.2017.06.137 | pmc=5708401 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29221325 }}</ref><ref name="pmid11444115">{{cite journal |vauthors=Rafanan AL, Mehta AC |title=Adult airway foreign body removal. What's new? |journal=Clin. Chest Med. |volume=22 |issue=2 |pages=319–30 |year=2001 |pmid=11444115 |doi= |url=}}</ref><ref name="pmid26568942">{{cite journal| author=Haddadi S, Marzban S, Nemati S, Ranjbar Kiakelayeh S, Parvizi A, Heidarzadeh A| title=Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study. | journal=Iran J Otorhinolaryngol | year= 2015 | volume= 27 | issue= 82 | pages= 377-85 | pmid=26568942 | doi= | pmc=4639691 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26568942 }}</ref> | ||
* | | align="center" style="background:#F5F5F5;" + |Acute | ||
| align="center" style="background:#F5F5F5;" + | | |||
*Variable | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Wheeze|Wheezing]] | |||
*Decreased [[breath sounds]] | |||
| style="background:#F5F5F5;" + | | |||
*No specific tests | |||
| style="background:#F5F5F5;" + | | |||
*Hyperinflated lungs, [[atelectasis]], and [[mediastinitis]] | |||
*Shift in [[Chest X-ray|chest radiograph]] when the object is [[Radio-opaque|radio−opaque]] | |||
*[[Computed tomography|CT]] may be helpful | |||
| style="background:#F5F5F5;" + | | |||
*Not specific | |||
| style="background:#F5F5F5;" + | | |||
*[[Bronchoscopy]] | |||
| style="background:#F5F5F5;" + | | |||
*In children <1 year and adults >75 years | |||
*Organic materials in children | |||
*Inorganic materials in adults | |||
|- | |||
| align="center" style="background:#DCDCDC;" + |[[Bronchiolitis|'''Bronchiolitis''']]<ref name="pmid14757603">{{cite journal |vauthors=Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L, Lohr KN |title=Diagnosis and testing in bronchiolitis: a systematic review |journal=Arch Pediatr Adolesc Med |volume=158 |issue=2 |pages=119–26 |year=2004 |pmid=14757603 |doi=10.1001/archpedi.158.2.119 |url=}}</ref><ref name="urlwww.nice.org.uk">{{cite web |url=https://www.nice.org.uk/guidance/ng9/resources/bronchiolitis-in-children-diagnosis-and-management-pdf-51048523717 |title=www.nice.org.uk |format= |work= |accessdate=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Acute | |||
| style="background:#F5F5F5;" + | | |||
*8−15 days | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Wheeze|Wheezing]] | |||
*[[Rales|Crackles]] | |||
*Increased [[respiratory rate]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Complete blood count]] ([[CBC]]) may be helpful | |||
*[[Urinalysis]] & [[urine culture]] ( in infants) | |||
| style="background:#F5F5F5;" + | | |||
*[[Chest X-Ray|Chest X−Ray]] may be helpful | |||
| style="background:#F5F5F5;" + | | |||
*Normal function or obstructive changes ([[FEV1/FVC ratio|FEV1/FVC]] <70%) | |||
*Air trapping in [[Lung volumes]] | |||
*Reduced [[DLCO|Diffusing capacity of carbon monoxide]] ( [[DLCO]]) | |||
| style="background:#F5F5F5;" + | | |||
*Clinical diagnosis | |||
| style="background:#F5F5F5;" + | | |||
*Etiology: Respiratory ''[[Human respiratory syncytial virus|syncytial virus]], [[Rhinovirus]]'' | |||
*Children <2 years | |||
|- | |||
! colspan="2" rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Organ system | |||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases | |||
! colspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical manifestations | |||
! colspan="4" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diagnosis | |||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Other features | |||
|- | |||
! colspan="7" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Physical exam | |||
|- | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Onset | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Duration | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Productive cough | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Hemoptysis | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Weight lost | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Ascultation | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Lab findings | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Imaging | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |PFT | |||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | |||
|- | |||
| rowspan="4" align="center" style="background:#DCDCDC;" + |[[Respiratory system|'''Respiratory''']] | |||
| rowspan="4" align="center" style="background:#DCDCDC;" + |[[Parenchyma|'''Parenchyma''']] | |||
| align="center" style="background:#DCDCDC;" + |[[Pneumonia|'''Pneumonia''']]<ref name="pmid10987697">{{cite journal |vauthors=Bartlett JG, Dowell SF, Mandell LA, File Jr TM, Musher DM, Fine MJ |title=Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America |journal=Clin. Infect. Dis. |volume=31 |issue=2 |pages=347–82 |year=2000 |pmid=10987697 |doi=10.1086/313954 |url=}}</ref><ref name="pmid17278083">{{cite journal |vauthors=Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG |title=Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults |journal=Clin. Infect. Dis. |volume=44 Suppl 2 |issue= |pages=S27–72 |year=2007 |pmid=17278083 |doi=10.1086/511159 |url=}}</ref> | |||
| align="center" style="background:#F5F5F5;" + |Acute | |||
| style="background:#F5F5F5;" + | | |||
*Variable | |||
| align="center" style="background:#F5F5F5;" + | + Mucopurulent [[sputum]] | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + |− | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| style="background:#F5F5F5;" + | | |||
*[[Rales|Crackles]] | |||
*[[Egophony]] | |||
*Decreased bronchial sounds | |||
| style="background:#F5F5F5;" + | | |||
*Leftward shift [[leukocytosis]] | |||
*[[Blood culture]] in hospitalized patients | |||
*[[Sputum culture]] in hospitalized patients | |||
| style="background:#F5F5F5;" + | | |||
*[[Consolidation (medicine)|Consolidation]], [[cavitation]], and infiltrated [[interstitial]] in [[Chest X-ray|chest X−ray]] | |||
*Anatomical changes observed in chest [[Computed tomography|CT]] | |||
| style="background:#F5F5F5;" + | | |||
*Not specific | |||
| style="background:#F5F5F5;" + | | |||
*Infiltration observed in [[Chest X-ray|chest X−ray]] | |||
| style="background:#F5F5F5;" + | | |||
*[[Community-acquired pneumonia|Community−acquired pneumonia]] | |||
*[[Healthcare-associated pneumonia|Healthcare−associated pneumonia]] | |||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |[[Lung cancer|'''Lung cancer''']]<ref name="pmid21296855">{{cite journal |vauthors=Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D |title=Global cancer statistics |journal=CA Cancer J Clin |volume=61 |issue=2 |pages=69–90 |year=2011 |pmid=21296855 |doi=10.3322/caac.20107 |url=}}</ref><ref name="pmid23649435">{{cite journal |vauthors=Ost DE, Jim Yeung SC, Tanoue LT, Gould MK |title=Clinical and organizational factors in the initial evaluation of patients with lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines |journal=Chest |volume=143 |issue=5 Suppl |pages=e121S–e141S |year=2013 |pmid=23649435 |pmc=4694609 |doi=10.1378/chest.12-2352 |url=}}</ref> | | align="center" style="background:#DCDCDC;" + |[[Lung cancer|'''Lung cancer''']]<ref name="pmid21296855">{{cite journal |vauthors=Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D |title=Global cancer statistics |journal=CA Cancer J Clin |volume=61 |issue=2 |pages=69–90 |year=2011 |pmid=21296855 |doi=10.3322/caac.20107 |url=}}</ref><ref name="pmid23649435">{{cite journal |vauthors=Ost DE, Jim Yeung SC, Tanoue LT, Gould MK |title=Clinical and organizational factors in the initial evaluation of patients with lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines |journal=Chest |volume=143 |issue=5 Suppl |pages=e121S–e141S |year=2013 |pmid=23649435 |pmc=4694609 |doi=10.1378/chest.12-2352 |url=}}</ref> | ||
Line 116: | Line 484: | ||
**[[Small cell lung cancer|Small cell lung cance]]<nowiki/>r ([[Small cell lung cancer|SCLC]]) | **[[Small cell lung cancer|Small cell lung cance]]<nowiki/>r ([[Small cell lung cancer|SCLC]]) | ||
**[[Non small cell lung cancer|Non−small cell lung cance]]<nowiki/>r ([[Non small cell lung cancer|NSCLC]]) | **[[Non small cell lung cancer|Non−small cell lung cance]]<nowiki/>r ([[Non small cell lung cancer|NSCLC]]) | ||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |'''[[Tuberculosis]] ([[Tuberculosis|TB]])'''<ref name="pmid9332519">{{cite journal |vauthors=Perlman DC, el-Sadr WM, Nelson ET, Matts JP, Telzak EE, Salomon N, Chirgwin K, Hafner R |title=Variation of chest radiographic patterns in pulmonary tuberculosis by degree of human immunodeficiency virus-related immunosuppression. The Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA). The AIDS Clinical Trials Group (ACTG) |journal=Clin. Infect. Dis. |volume=25 |issue=2 |pages=242–6 |year=1997 |pmid=9332519 |doi= |url=}}</ref><ref name="pmid2456183">{{cite journal |vauthors=Barnes PF, Verdegem TD, Vachon LA, Leedom JM, Overturf GD |title=Chest roentgenogram in pulmonary tuberculosis. New data on an old test |journal=Chest |volume=94 |issue=2 |pages=316–20 |year=1988 |pmid=2456183 |doi= |url=}}</ref> | | align="center" style="background:#DCDCDC;" + |'''[[Tuberculosis]] ([[Tuberculosis|TB]])'''<ref name="pmid9332519">{{cite journal |vauthors=Perlman DC, el-Sadr WM, Nelson ET, Matts JP, Telzak EE, Salomon N, Chirgwin K, Hafner R |title=Variation of chest radiographic patterns in pulmonary tuberculosis by degree of human immunodeficiency virus-related immunosuppression. The Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA). The AIDS Clinical Trials Group (ACTG) |journal=Clin. Infect. Dis. |volume=25 |issue=2 |pages=242–6 |year=1997 |pmid=9332519 |doi= |url=}}</ref><ref name="pmid2456183">{{cite journal |vauthors=Barnes PF, Verdegem TD, Vachon LA, Leedom JM, Overturf GD |title=Chest roentgenogram in pulmonary tuberculosis. New data on an old test |journal=Chest |volume=94 |issue=2 |pages=316–20 |year=1988 |pmid=2456183 |doi= |url=}}</ref> | ||
Line 271: | Line 608: | ||
*[[Echocardiography]] | *[[Echocardiography]] | ||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |[[ | | align="center" style="background:#DCDCDC;" + |[[Mitral stenosis|'''Mitral Stenosis''']]<ref name="pmid13936649">{{cite journal| author=MUNROE DS, RALLY CR| title=The diagnosis of mitral stenosis. | journal=Can Med Assoc J | year= 1963 | volume= 88 | issue= | pages= 611-22 | pmid=13936649 | doi= | pmc=1921207 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13936649 }}</ref><ref name="pmid19747723">{{cite journal |vauthors=Chandrashekhar Y, Westaby S, Narula J |title=Mitral stenosis |journal=Lancet |volume=374 |issue=9697 |pages=1271–83 |year=2009 |pmid=19747723 |doi=10.1016/S0140-6736(09)60994-6 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Chronic | | align="center" style="background:#F5F5F5;" + |Chronic | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Variable | ||
| align="center" style="background:#F5F5F5;" + | + Pink frothy | |||
| align="center" style="background:#F5F5F5;" + | + | |||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
| align="center" style="background:#F5F5F5;" + | + | | align="center" style="background:#F5F5F5;" + | + | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Crackles]] | ||
| style="background:#F5F5F5;" + | | *[[Hoarseness]] | ||
| style="background:#F5F5F5;" + | | |||
* | *Not specifc | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*Enlargement of | *[[Electrocardiogram]] may be helpful | ||
*Enlargement of [[left atrium]] and [[appendage]] in [[Chest X-ray|chest radiograph]] | |||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *[[Vital capacity|FVC]] reduced | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
* | *Resting [[transthoracic echocardiography]] | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*[[ | *[[Stress testing]] | ||
*[[ | *[[Cardiac catheterization]] | ||
|- | |- | ||
| colspan="2" align="center" style="background:#DCDCDC;" + |[[Gastrointestinal tract|'''Gastrointestinal''']] | | colspan="2" align="center" style="background:#DCDCDC;" + |[[Gastrointestinal tract|'''Gastrointestinal''']] | ||
Line 348: | Line 679: | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Gold standard | ||
|- | |- | ||
| colspan="2" rowspan=" | | colspan="2" rowspan="3" align="center" style="background:#DCDCDC;" + |'''[[Autoimmune]]''' | ||
| align="center" style="background:#DCDCDC;" + |[[Granulomatosis with polyangiitis|'''Wegener's disease''']] ([[Granulomatosis with polyangiitis|'''GPA''']]) <ref name="pmid1739240">{{cite journal |vauthors=Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS |title=Wegener granulomatosis: an analysis of 158 patients |journal=Ann. Intern. Med. |volume=116 |issue=6 |pages=488–98 |year=1992 |pmid=1739240 |doi= |url=}}</ref><ref name="pmid21374588">{{cite journal |vauthors=Falk RJ, Gross WL, Guillevin L, Hoffman GS, Jayne DR, Jennette JC, Kallenberg CG, Luqmani R, Mahr AD, Matteson EL, Merkel PA, Specks U, Watts RA |title=Granulomatosis with polyangiitis (Wegener's): an alternative name for Wegener's granulomatosis |journal=Arthritis Rheum. |volume=63 |issue=4 |pages=863–4 |year=2011 |pmid=21374588 |doi=10.1002/art.30286 |url=}}</ref> | | align="center" style="background:#DCDCDC;" + |[[Granulomatosis with polyangiitis|'''Wegener's disease''']] ([[Granulomatosis with polyangiitis|'''GPA''']]) <ref name="pmid1739240">{{cite journal |vauthors=Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS |title=Wegener granulomatosis: an analysis of 158 patients |journal=Ann. Intern. Med. |volume=116 |issue=6 |pages=488–98 |year=1992 |pmid=1739240 |doi= |url=}}</ref><ref name="pmid21374588">{{cite journal |vauthors=Falk RJ, Gross WL, Guillevin L, Hoffman GS, Jayne DR, Jennette JC, Kallenberg CG, Luqmani R, Mahr AD, Matteson EL, Merkel PA, Specks U, Watts RA |title=Granulomatosis with polyangiitis (Wegener's): an alternative name for Wegener's granulomatosis |journal=Arthritis Rheum. |volume=63 |issue=4 |pages=863–4 |year=2011 |pmid=21374588 |doi=10.1002/art.30286 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |Chronic | | align="center" style="background:#F5F5F5;" + |Chronic | ||
Line 382: | Line 713: | ||
*[[Saddle nose|Saddle nose deformity]] | *[[Saddle nose|Saddle nose deformity]] | ||
*[[Purpura]] in lower extremities | *[[Purpura]] in lower extremities | ||
|- | |- | ||
| align="center" style="background:#DCDCDC;" + |'''Microscopic polyangitis ([[Microscopic polyangiitis|MPA]])'''<ref name="JennetteFalk1997">{{cite journal|last1=Jennette|first1=J. Charles|last2=Falk|first2=Ronald J.|title=Small-Vessel Vasculitis|journal=New England Journal of Medicine|volume=337|issue=21|year=1997|pages=1512–1523|issn=0028-4793|doi=10.1056/NEJM199711203372106}}</ref> | | align="center" style="background:#DCDCDC;" + |'''Microscopic polyangitis ([[Microscopic polyangiitis|MPA]])'''<ref name="JennetteFalk1997">{{cite journal|last1=Jennette|first1=J. Charles|last2=Falk|first2=Ronald J.|title=Small-Vessel Vasculitis|journal=New England Journal of Medicine|volume=337|issue=21|year=1997|pages=1512–1523|issn=0028-4793|doi=10.1056/NEJM199711203372106}}</ref> | ||
Line 484: | Line 779: | ||
*[[Rhinosinusitis]] | *[[Rhinosinusitis]] | ||
|} | |} | ||
==References== | |||
{{Reflist|2}} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Revision as of 20:27, 3 April 2018
Aspiration pneumonia Microchapters | |
Diagnosis | |
---|---|
Treatment | |
Aspiration pneumonia differential diagnosis On the Web | |
American Roentgen Ray Society Images of Aspiration pneumonia differential diagnosis | |
Risk calculators and risk factors for Aspiration pneumonia differential diagnosis | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karina Zavaleta, MD [2], Anmol Pitliya, M.B.B.S. M.D.[3]
Aspiration pneumonia differential diagnosis
Aspiration pneumonia must be differentiated from other diseases that cause productive cough, fever, and dyspnea.
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical exam | ||||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
Respiratory | Upper airway diseases | Croup[1] | Acute |
|
+ | − | − | + | + |
|
|
|
| ||
Pertussis[2][3] | Acute |
|
+ Whooping sound | − | + | + | + |
|
|
|
|
|
| ||
Laryngopharyngeal reflux[4][5] | Chronic |
|
+ | − | − | − | + |
|
|
|
| ||||
Common Cold[6] | Acute |
|
+ | − | − | + | − |
|
|
|
|
||||
Rhinosinusitis[7][8] | Acute, subacute, chronic, recurrent | + | − | − | + | + |
|
|
|
|
| ||||
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
Symptoms | Physical exam | ||||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
Respiratory | Lower airway | Asthma[9] | Chronic |
|
+ Clear mucoid or yellow sputum | − | − | − | + |
|
|
|
|
| |
Acute Bronchitis[10] | Acute |
|
+ | − | − | +/− | + |
|
|
|
|
| |||
Chronic Bronchitis[11][12] | Chronic |
|
+ Clear sputum | − | − | + | + |
|
|
|
| ||||
Non−asthmatic eosinophilic bronchitis[13][14] | Chronic |
|
+ Eosinophilic sputum | − | − | − | + |
|
|
|
| ||||
Bronchiectasis[15] | Chronic |
|
+ Mucopurulent sputum | + | − | − | + |
|
|
|
| ||||
Emphysema [16] | Chronic |
|
+ Mucoid or purulent sputum | − | − | + | + |
|
|
|
|
| |||
Foreing body aspiration[17][18][19] | Acute |
|
+ | + | − | + | + |
|
|
|
|
| |||
Bronchiolitis[20][21] | Acute |
|
+ | − | − | + | + |
|
|
|
|
|
| ||
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
Symptoms | Physical exam | ||||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
Respiratory | Parenchyma | Pneumonia[22][23] | Acute |
|
+ Mucopurulent sputum | − | − | + | + |
|
|
|
|
||
Lung cancer[24][25] | Chronic |
|
+ | + | + | +/− | + | The following investigations may be helpful: |
|
|
| ||||
Tuberculosis (TB)[26][27] | Chronic |
|
+ | + | + | + | + |
|
|
|
|
| |||
Cystic fibrosis (CF)[28][29] | Chronic |
|
+ | − | + | +/− | + |
|
|
| |||||
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
Symptoms | Physical exam | ||||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
Cardiac | Cardiogenic pulmonary edema[30][31] | Acute |
|
+ Pink frothy, liquid | − | + | − | + |
|
The following investigations may be helpful: |
|
|
|
| |
Mitral Stenosis[32][33] | Chronic |
|
+ Pink frothy | + | − | − | + |
|
|
|
|
||||
Gastrointestinal | Gastroesophageal reflux[34][35] | Chronic |
|
+ | − | + | − | + |
|
|
|
|
−− | ||
Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
Symptoms | Physical exam | ||||||||||||||
Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
Autoimmune | Wegener's disease (GPA) [36][37] | Chronic |
|
+ | + | + | + | + | The following investigations may be helpful: |
|
|
|
| ||
Microscopic polyangitis (MPA)[38] | Chronic |
|
+ | + | + | + | + | The following investigations may be helpful:
|
|
|
|
| |||
Churg−Strauss[39][40] | Chronic |
|
+ | + | + | + | + |
|
|
|
|
References
- ↑ Cherry, James D. (2008). "Croup". New England Journal of Medicine. 358 (4): 384–391. doi:10.1056/NEJMcp072022. ISSN 0028-4793.
- ↑ Bellamy EA, Johnston ID, Wilson AG (1987). "The chest radiograph in whooping cough". Clin Radiol. 38 (1): 39–43. PMID 3816065.
- ↑ "Pertussis | Whooping Cough | Clinical | Information | CDC".
- ↑ "What is LPR? | American Academy of Otolaryngology-Head and Neck Surgery".
- ↑ Noordzij JP, Khidr A, Desper E, Meek RB, Reibel JF, Levine PA (2002). "Correlation of pH probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis". Laryngoscope. 112 (12): 2192–5. doi:10.1097/00005537-200212000-00013. PMID 12461340.
- ↑ Eccles R (2005). "Understanding the symptoms of the common cold and influenza". Lancet Infect Dis. 5 (11): 718–25. doi:10.1016/S1473-3099(05)70270-X. PMID 16253889.
- ↑ Meltzer EO, Hamilos DL (2011). "Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines". Mayo Clin Proc. 86 (5): 427–43. doi:10.4065/mcp.2010.0392. PMC 3084646. PMID 21490181.
- ↑ Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD (2015). "Clinical practice guideline (update): adult sinusitis". Otolaryngol Head Neck Surg. 152 (2 Suppl): S1–S39. doi:10.1177/0194599815572097. PMID 25832968.
- ↑ Ukena D, Fishman L, Niebling WB (2008). "Bronchial asthma: diagnosis and long-term treatment in adults". Dtsch Arztebl Int. 105 (21): 385–94. doi:10.3238/arztebl.2008.0385. PMC 2696883. PMID 19626179.
- ↑ Wenzel RP, Fowler AA (2006). "Clinical practice. Acute bronchitis". N. Engl. J. Med. 355 (20): 2125–30. doi:10.1056/NEJMcp061493. PMID 17108344.
- ↑ Brusasco V, Martinez F (2014). "Chronic obstructive pulmonary disease". Compr Physiol. 4 (1): 1–31. doi:10.1002/cphy.c110037. PMID 24692133.
- ↑ Qaseem A, Snow V, Shekelle P, Sherif K, Wilt TJ, Weinberger S, Owens DK (2007). "Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline from the American College of Physicians". Ann. Intern. Med. 147 (9): 633–8. PMID 17975186.
- ↑ Brightling CE (2006). "Chronic cough due to nonasthmatic eosinophilic bronchitis: ACCP evidence-based clinical practice guidelines". Chest. 129 (1 Suppl): 116S–121S. doi:10.1378/chest.129.1_suppl.116S. PMID 16428700.
- ↑ Cho J, Choi SM, Lee J, Park YS, Lee SM, Yoo CG; et al. (2018). "Clinical Outcome of Eosinophilic Airway Inflammation in Chronic Airway Diseases Including Nonasthmatic Eosinophilic Bronchitis". Sci Rep. 8 (1): 146. doi:10.1038/s41598-017-18265-2. PMC 5760521. PMID 29317659.
- ↑ King PT, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW (2006). "Characterisation of the onset and presenting clinical features of adult bronchiectasis". Respir Med. 100 (12): 2183–9. doi:10.1016/j.rmed.2006.03.012. PMID 16650970.
- ↑ Rossi A, Butorac-Petanjek B, Chilosi M, Cosío BG, Flezar M, Koulouris N; et al. (2017). "Chronic obstructive pulmonary disease with mild airflow limitation: current knowledge and proposal for future research - a consensus document from six scientific societies". Int J Chron Obstruct Pulmon Dis. 12: 2593–2610. doi:10.2147/COPD.S132236. PMC 5587130. PMID 28919728.
- ↑ Hewlett JC, Rickman OB, Lentz RJ, Prakash UB, Maldonado F (2017). "Foreign body aspiration in adult airways: therapeutic approach". J Thorac Dis. 9 (9): 3398–3409. doi:10.21037/jtd.2017.06.137. PMC 5708401. PMID 29221325.
- ↑ Rafanan AL, Mehta AC (2001). "Adult airway foreign body removal. What's new?". Clin. Chest Med. 22 (2): 319–30. PMID 11444115.
- ↑ Haddadi S, Marzban S, Nemati S, Ranjbar Kiakelayeh S, Parvizi A, Heidarzadeh A (2015). "Tracheobronchial Foreign-Bodies in Children; A 7 Year Retrospective Study". Iran J Otorhinolaryngol. 27 (82): 377–85. PMC 4639691. PMID 26568942.
- ↑ Bordley WC, Viswanathan M, King VJ, Sutton SF, Jackman AM, Sterling L, Lohr KN (2004). "Diagnosis and testing in bronchiolitis: a systematic review". Arch Pediatr Adolesc Med. 158 (2): 119–26. doi:10.1001/archpedi.158.2.119. PMID 14757603.
- ↑ "www.nice.org.uk".
- ↑ Bartlett JG, Dowell SF, Mandell LA, File Jr TM, Musher DM, Fine MJ (2000). "Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America". Clin. Infect. Dis. 31 (2): 347–82. doi:10.1086/313954. PMID 10987697.
- ↑ Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG (2007). "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults". Clin. Infect. Dis. 44 Suppl 2: S27–72. doi:10.1086/511159. PMID 17278083.
- ↑ Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011). "Global cancer statistics". CA Cancer J Clin. 61 (2): 69–90. doi:10.3322/caac.20107. PMID 21296855.
- ↑ Ost DE, Jim Yeung SC, Tanoue LT, Gould MK (2013). "Clinical and organizational factors in the initial evaluation of patients with lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines". Chest. 143 (5 Suppl): e121S–e141S. doi:10.1378/chest.12-2352. PMC 4694609. PMID 23649435.
- ↑ Perlman DC, el-Sadr WM, Nelson ET, Matts JP, Telzak EE, Salomon N, Chirgwin K, Hafner R (1997). "Variation of chest radiographic patterns in pulmonary tuberculosis by degree of human immunodeficiency virus-related immunosuppression. The Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA). The AIDS Clinical Trials Group (ACTG)". Clin. Infect. Dis. 25 (2): 242–6. PMID 9332519.
- ↑ Barnes PF, Verdegem TD, Vachon LA, Leedom JM, Overturf GD (1988). "Chest roentgenogram in pulmonary tuberculosis. New data on an old test". Chest. 94 (2): 316–20. PMID 2456183.
- ↑ Farrell PM, Rosenstein BJ, White TB, Accurso FJ, Castellani C, Cutting GR, Durie PR, Legrys VA, Massie J, Parad RB, Rock MJ, Campbell PW (2008). "Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report". J. Pediatr. 153 (2): S4–S14. doi:10.1016/j.jpeds.2008.05.005. PMC 2810958. PMID 18639722.
- ↑ Kerem E, Reisman J, Corey M, Canny GJ, Levison H (1992). "Prediction of mortality in patients with cystic fibrosis". N. Engl. J. Med. 326 (18): 1187–91. doi:10.1056/NEJM199204303261804. PMID 1285737.
- ↑ Gheorghiade M, Zannad F, Sopko G, Klein L, Piña IL, Konstam MA, Massie BM, Roland E, Targum S, Collins SP, Filippatos G, Tavazzi L (2005). "Acute heart failure syndromes: current state and framework for future research". Circulation. 112 (25): 3958–68. doi:10.1161/CIRCULATIONAHA.105.590091. PMID 16365214.
- ↑ Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (2013). "2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines". Circulation. 128 (16): e240–327. doi:10.1161/CIR.0b013e31829e8776. PMID 23741058.
- ↑ MUNROE DS, RALLY CR (1963). "The diagnosis of mitral stenosis". Can Med Assoc J. 88: 611–22. PMC 1921207. PMID 13936649.
- ↑ Chandrashekhar Y, Westaby S, Narula J (2009). "Mitral stenosis". Lancet. 374 (9697): 1271–83. doi:10.1016/S0140-6736(09)60994-6. PMID 19747723.
- ↑ Kahrilas PJ, Hughes N, Howden CW (2011). "Response of unexplained chest pain to proton pump inhibitor treatment in patients with and without objective evidence of gastro-oesophageal reflux disease". Gut. 60 (11): 1473–8. doi:10.1136/gut.2011.241307. PMID 21508423.
- ↑ Badillo R, Francis D (2014). "Diagnosis and treatment of gastroesophageal reflux disease". World J Gastrointest Pharmacol Ther. 5 (3): 105–12. doi:10.4292/wjgpt.v5.i3.105. PMC 4133436. PMID 25133039.
- ↑ Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, Rottem M, Fauci AS (1992). "Wegener granulomatosis: an analysis of 158 patients". Ann. Intern. Med. 116 (6): 488–98. PMID 1739240.
- ↑ Falk RJ, Gross WL, Guillevin L, Hoffman GS, Jayne DR, Jennette JC, Kallenberg CG, Luqmani R, Mahr AD, Matteson EL, Merkel PA, Specks U, Watts RA (2011). "Granulomatosis with polyangiitis (Wegener's): an alternative name for Wegener's granulomatosis". Arthritis Rheum. 63 (4): 863–4. doi:10.1002/art.30286. PMID 21374588.
- ↑ Jennette, J. Charles; Falk, Ronald J. (1997). "Small-Vessel Vasculitis". New England Journal of Medicine. 337 (21): 1512–1523. doi:10.1056/NEJM199711203372106. ISSN 0028-4793.
- ↑ Vaglio A, Buzio C, Zwerina J (2013). "Eosinophilic granulomatosis with polyangiitis (Churg-Strauss): state of the art". Allergy. 68 (3): 261–73. doi:10.1111/all.12088. PMID 23330816.
- ↑ Lanham JG, Elkon KB, Pusey CD, Hughes GR (1984). "Systemic vasculitis with asthma and eosinophilia: a clinical approach to the Churg-Strauss syndrome". Medicine (Baltimore). 63 (2): 65–81. PMID 6366453.