Differentials
Coronavirus disease 2019 (COVID-19)
SIGNS / SYMPTOMS
Residence in/travel to a country/area or territory with local transmission, or close contact with a confirmed or probable case of COVID-19, in the 14 days prior to symptom onset.
Signs and symptoms are similar so it may be difficult to differentiate between the conditions clinically.
The situation is evolving rapidly; see our COVID-19 topic for further information.
INVESTIGATIONS
Real-time reverse transcription polymerase chain reaction (RT-PCR): positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA.
It is not possible to differentiate COVID-19 from other causes of pneumonia on chest imaging.
Mycoplasma pneumoniae pneumonia
SIGNS / SYMPTOMS
Cannot be differentiated clinically or by routine laboratory tests. Co-infections with M pneumoniae, Chlamydia pneumoniae, and other bacteria are not uncommon.[1][11]
INVESTIGATIONS
Demonstration of seroconversion in paired sera, presence of anti-M pneumoniae IgM antibody in children aged 10 or under (several FDA-approved tests are available), demonstration of presence of M pneumoniae by culture and/or PCR.
Pneumonia, bacterial
SIGNS / SYMPTOMS
Patients with pneumococcal pneumonia may be more ill, and are more likely to have comorbidities, but presentations overlap significantly.[11]
INVESTIGATIONS
Positive culture for Streptococcus pneumoniae or other bacteria in sputum, blood, and/or pleural fluid.
Viral pneumonia
SIGNS / SYMPTOMS
Similar presentation with wheezing present.
INVESTIGATIONS
Chest x-ray unlikely to show consolidation or pleural effusions.
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