Differential diagnosis

A. Acute bronchitis or pneumonia can present with fever, constitutional symptoms and a productive cough. Patients with pneumonia often have rales. When pneumonia is suspected on the basis of the presence of a high fever, constitutional symptoms or severe dyspnea, a chest radiograph should be obtained.

Differential Diagnosis of Acute Bronchitis

Disease process

Signs and symptoms

Asthma

Evidence of reversible airway obstruction even when not infected

Allergic aspergillosis

Transient pulmonary infiltrates

Eosinophilia in sputum and peripheral blood smear

Occupational exposures

Symptoms worse during the work week but tend to improve during weekends, holidays and vacations

Chronic bronchitis

Chronic cough with sputum production on a daily basis for a minimum of three months Typically occurs in smokers

Sinusitis

Tenderness over the sinuses, postnasal drainage

Common cold

Upper airway inflammation and no evidence of bronchial wheezing

Pneumonia

Evidence of infiltrate on the chest radiograph

Congestive heart failure

Basilar rales

Orthopnea

Cardiomegaly

Evidence of increased interstitial or alveolar fluid on the chest radiograph

S3 gallop

Tachycardia

Reflux esophagitis

Intermittent symptoms worse when lying down Heartburn

Disease process

Signs and symptoms

Bronchogenic tumor

Constitutional signs often present Cough chronic, sometimes with hemoptysis

Aspiration syndromes

Usually related to a precipitating event, such as smoke inhalation

Vomiting

Decreased level of consciousness

B. Asthma should be considered in patients with repetitive episodes of acute bronchitis. Patients who repeatedly present with cough and wheezing can be given spirometric testing with bronchodilation to help differentiate asthma from recurrent bronchitis.

C. Congestive heart failure may cause cough, shortness of breath and wheezing in older patients. Reflux esophagitis with chronic aspiration can cause bronchial inflammation with cough and wheezing. Bronchogenic tumors may produce a cough and obstructive symptoms.

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Responses

  • Hildibrand
    What is the home remedy for gallops and suffucication?
    3 years ago

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