Bronchiectasis differential diagnosis

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Overview

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

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


References

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