COVID-19-associated pneumonia differential diagnosis: Difference between revisions

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__NOTOC__
__NOTOC__
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/COVID-19-associated_pneumonia]]
{{CMG}}; {{AE}} {{Usman Ali Akbar}}
{{CMG}}; {{AE}} {{Usman Ali Akbar}}
==Overview==
==Overview==
COVID-19-associated pneumonia should be diffrentiated from other Diseases.
COVID-19-associated pneumonia should be differentiated from other Diseases.
==Differentiating COVID-19-associated pneumonia from other Diseases==
==Differentiating COVID-19-associated pneumonia from other Diseases==
* COVID-19-associated pneumonia should be diffrentiated from other Diseases.
* COVID-19-associated pneumonia should be diffrentiated from other Diseases.
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! style="background: #4479BA; width: 500px;" |{{fontcolor|#FFF|Findings}}
! style="background: #4479BA; width: 500px;" |{{fontcolor|#FFF|Findings}}
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! style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[COVID-19 associated pneumonia]]<ref name="pmid1458569">{{cite journal| author=Schiele F, Muller J, Colinet E, Siest G, Arzoglou P, Brettschneider H et al.| title=Interlaboratory study of the IFCC method for alanine aminotransferase performed with use of a partly purified reference material. | journal=Clin Chem | year= 1992 | volume= 38 | issue= 12 | pages= 2365-71 | pmid=1458569 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1458569  }} </ref><ref name="pmid11113658">{{cite journal| author=Castro-Guardiola A, Armengou-Arxé A, Viejo-Rodríguez A, Peñarroja-Matutano G, Garcia-Bragado F| title=Differential diagnosis between community-acquired pneumonia and non-pneumonia diseases of the chest in the emergency ward. | journal=Eur J Intern Med | year= 2000 | volume= 11 | issue= 6 | pages= 334-339 | pmid=11113658 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11113658  }} </ref><ref name="Ahnsjö1935">{{cite journal|last1=Ahnsjö|first1=Sven|title=Contribution to the Differential Diagnosis of Pneumonia in Childhood|journal=Acta Paediatrica|volume=17|issue=3|year=1935|pages=439–446|issn=0803-5253|doi=10.1111/j.1651-2227.1935.tb07697.x}}</ref><ref name="CEBM 2020" />
! style="padding: 5px 5px; background: #DCDCDC; |[[COVID-19 associated pneumonia]]<ref name="pmid1458569">{{cite journal| author=Schiele F, Muller J, Colinet E, Siest G, Arzoglou P, Brettschneider H et al.| title=Interlaboratory study of the IFCC method for alanine aminotransferase performed with use of a partly purified reference material. | journal=Clin Chem | year= 1992 | volume= 38 | issue= 12 | pages= 2365-71 | pmid=1458569 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1458569  }} </ref><ref name="pmid11113658">{{cite journal| author=Castro-Guardiola A, Armengou-Arxé A, Viejo-Rodríguez A, Peñarroja-Matutano G, Garcia-Bragado F| title=Differential diagnosis between community-acquired pneumonia and non-pneumonia diseases of the chest in the emergency ward. | journal=Eur J Intern Med | year= 2000 | volume= 11 | issue= 6 | pages= 334-339 | pmid=11113658 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11113658  }} </ref><ref name="Ahnsjö1935">{{cite journal|last1=Ahnsjö|first1=Sven|title=Contribution to the Differential Diagnosis of Pneumonia in Childhood|journal=Acta Paediatrica|volume=17|issue=3|year=1935|pages=439–446|issn=0803-5253|doi=10.1111/j.1651-2227.1935.tb07697.x}}</ref><ref name="CEBM 2020" />
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*COVID-19 associated pneumonia can be classified from other '''viral pneumonia''' caused based on history of exposure to [[COVID-19]], positive [[SARS-CoV-2|SARS-CoV-2 PCR]], [[dyspnea]], [[Fever|fever,]] [[cough]], expectoration and uncommon associated findings like [[diarrhea]], [[headache]],[[vomiting]] and [[Myalgia|myalgias]].
*COVID-19 associated pneumonia can be classified from other '''viral pneumonia''' caused based on history of exposure to [[COVID-19]], positive [[SARS-CoV-2|SARS-CoV-2 PCR]], [[dyspnea]], [[Fever|fever,]] [[cough]], expectoration and uncommon associated findings like [[diarrhea]], [[headache]],[[vomiting]] and [[Myalgia|myalgias]].
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*CT-scan chest may show classical appearances of sub-pleural organizing areas of [[Consolidation (medicine)|consolidation]] with patchy peripheral ground-glass opacities.
*CT-scan chest may show classical appearances of sub-pleural organizing areas of [[Consolidation (medicine)|consolidation]] with patchy peripheral ground-glass opacities.
|-
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Acute bronchitis]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Acute bronchitis]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* No infiltrates seen on the chest X-ray.
* No infiltrates seen on the chest X-ray.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Asthma]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Asthma]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Past medical history
* Past medical history
* No infiltrates seen on chest X-ray.
* No infiltrates seen on chest X-ray.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Bronchiolitis obliterans]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Bronchiolitis obliterans]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Should be suspected in patients with pneumonia who do not respond to antibiotics treatment.
* Should be suspected in patients with pneumonia who do not respond to antibiotics treatment.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Congestive heart failure]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Congestive heart failure]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Bilateral [[pulmonary edema]]
* Bilateral [[pulmonary edema]]
* Shortness of breath
* Shortness of breath
|-
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[COPD]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[COPD]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Past medical history
* Past medical history
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* Fever is uncommon.
* Fever is uncommon.
|-
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Empyema]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Empyema]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* CXR showing features of: [[pleural effusion]].
* CXR showing features of: [[pleural effusion]].
* Inflammatory markers on [[thoracocentesis]].
* Inflammatory markers on [[thoracocentesis]].
|-
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Endocarditis]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Endocarditis]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Finding of septic [[pulmonary emboli]]
* Finding of septic [[pulmonary emboli]]
|-
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Gastroesophageal reflux disease]] (GERD)
| style="padding: 5px 5px; background: #DCDCDC;" |[[Gastroesophageal reflux disease]] (GERD)
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Normal chest X-ray
* Normal chest X-ray
* Symptoms are worse at night and associated with meals.
* Symptoms are worse at night and associated with meals.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Lung abscess]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Lung abscess]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Chest X-ray shows signs of [[lung abscess]].
* Chest X-ray shows signs of [[lung abscess]].
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Lung cancer]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Lung cancer]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Weight loss
* Weight loss
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* CT scan and biopsy are helpful in ruling out malignancy.
* CT scan and biopsy are helpful in ruling out malignancy.
|-
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Pertussis]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Pertussis]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Productive cough for weeks
* Productive cough for weeks
* Nasopharyngeal aspirate aids in diagnosis.
* Nasopharyngeal aspirate aids in diagnosis.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Pulmonary embolus]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Pulmonary embolus]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* A high degree of suspicion should be kept for [[pulmonary embolus]].
* A high degree of suspicion should be kept for [[pulmonary embolus]].
* A chest X-ray may be normal.
* A chest X-ray may be normal.
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Sinusitis]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Sinusitis]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Sinus tenderness
* Sinus tenderness
* Post-nasal drip
* Post-nasal drip
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Vasculitis]]
| style="padding: 5px 5px; background: #DCDCDC;" |[[Vasculitis]]
| style="padding: 5px 5px; background: #F5F5F5;" |
| style="padding: 5px 5px; background: #F5F5F5;" |
* Systemic manifestations of [[collagen vascular disease]] may be seen.
* Systemic manifestations of [[collagen vascular disease]] may be seen.


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Revision as of 03:49, 21 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usman Ali Akbar, M.B.B.S.[2]

Overview

COVID-19-associated pneumonia should be differentiated from other Diseases.

Differentiating COVID-19-associated pneumonia from other Diseases

  • COVID-19-associated pneumonia should be diffrentiated from other Diseases.
Differential Diagnosis of COVID-associated Pneumonia
Disease Findings
COVID-19 associated pneumonia[1][2][3][4]
  • COVID-19 associated pneumonia can be classified from other viral pneumonia caused based on history of exposure to COVID-19, positive SARS-CoV-2 PCR, dyspnea, fever, cough, expectoration and uncommon associated findings like diarrhea, headache,vomiting and myalgias.
  • Chest X-ray and other imaging modalities can further help us differentiate COVID-19 associated pneumonia from other causes.
  • Chest X-ray usually shows bilateral, almost symmetrical areas of peripheral consolidation with perihilar infiltrates, and an indistinct left heart border.
  • CT-scan chest may show classical appearances of sub-pleural organizing areas of consolidation with patchy peripheral ground-glass opacities.
Acute bronchitis
  • No infiltrates seen on the chest X-ray.
Asthma
  • Past medical history
  • No infiltrates seen on chest X-ray.
Bronchiolitis obliterans
  • Should be suspected in patients with pneumonia who do not respond to antibiotics treatment.
Congestive heart failure
COPD
  • Past medical history
  • No infiltrates on chest X-ray
  • Fever is uncommon.
Empyema
Endocarditis
Gastroesophageal reflux disease (GERD)
  • Normal chest X-ray
  • Symptoms are worse at night and associated with meals.
Lung abscess
Lung cancer
  • Weight loss
  • Clear sputum
  • CT scan and biopsy are helpful in ruling out malignancy.
Pertussis
  • Productive cough for weeks
  • Nasopharyngeal aspirate aids in diagnosis.
Pulmonary embolus
  • A high degree of suspicion should be kept for pulmonary embolus.
  • A chest X-ray may be normal.
Sinusitis
  • Sinus tenderness
  • Post-nasal drip
Vasculitis
  1. ↑ Schiele F, Muller J, Colinet E, Siest G, Arzoglou P, Brettschneider H; et al. (1992). "Interlaboratory study of the IFCC method for alanine aminotransferase performed with use of a partly purified reference material". Clin Chem. 38 (12): 2365–71. PMID 1458569.
  2. ↑ Castro-Guardiola A, Armengou-Arxé A, Viejo-Rodríguez A, Peñarroja-Matutano G, Garcia-Bragado F (2000). "Differential diagnosis between community-acquired pneumonia and non-pneumonia diseases of the chest in the emergency ward". Eur J Intern Med. 11 (6): 334–339. PMID 11113658.
  3. ↑ Ahnsjö, Sven (1935). "Contribution to the Differential Diagnosis of Pneumonia in Childhood". Acta Paediatrica. 17 (3): 439–446. doi:10.1111/j.1651-2227.1935.tb07697.x. ISSN 0803-5253.
  4. ↑
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