Bronchiectasis differential diagnosis

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Bronchiectasis Differential Diagnosis

• Chronic Obstructive Pulmonary Disease (COPD)

• Diminished breath sounds in COPD are not found in bronchiectasis
• Chest CT will be normal or show emphysema is patients with COPD

• Asthma

• Crackles found in bronchiectasis will not be found in asthma
• Airflow obstruction is reversible in asthma

• Pneumonia

• Patients with pneumonia will express symptoms for a short duration of 7-10 days, whereas patients with with bronchiectasis express symptoms for years
• Patients with pneumonia have bronchial breath sounds on auscultation
• Consolidation is seen on chest x-ray and chest CT in patients with pneumonia

• Tuberculosis

• Chronic Sinusitis

• Crackles found in bronchiectasis will not be found in chronic sinusitis
• Chest x-ray and chest CT are normal in chronic sinusitis

• Cough due to gastrointestinal reflux
• Upper airway cough syndrome (postnasal drip)
• Cancer of the lung
• Inhaled foreign body

Features that may suggest bronchiectasis in a patient presenting with chronic respiratory symptoms

• Digital clubbing
• Lack of a significant smoking history if you suspect a patient has COPD
• History of recurrent and/or severe pneumonia or tuberculosis
• Presence of Aspergillus, atypical/nontuberculous mycobacteria, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae in the sputum
• If the childhood is associated with significant environmental and social disadvantage