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Clinical mimics: an emergency medicine focused review of pneumonia mimics

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Abstract

Pneumonia is a common cause of morbidity and mortality in adults in the United States. While pneumonia classically presents with a fever, cough, and shortness of breath, the presentation can vary widely in adults. This review evaluates history and physical examination findings of pneumonia and several conditions that mimic pneumonia. Pneumonia is a potentially deadly disease. History and examination findings are variable in pneumonia, and many conditions mimic pneumonia. These conditions include pulmonary embolism, diffuse interstitial lung disease, endocarditis, vasculitis, diffuse alveolar hemorrhage, acute decompensated heart failure, tuberculosis, lung cancer, and acute respiratory distress syndrome. Emergency clinicians should assess the patient while resuscitation occurs. Early antibiotics and the diagnosis of pneumonia can improve outcomes. Key historical and physical examination findings may lead the clinician to consider other conditions that require immediate management. Using clinical evaluation and adjunctive imaging, these conditions can be diagnosed and treated. Knowledge of pneumonia mimics is vital for the care of patients with respiratory complaints. Pneumonia is common and may be deadly, and emergency clinicians must differentiate conditions that mimic pneumonia. Rapid evaluation and management may alleviate morbidity and mortality for each of these conditions. The history and physical examination, in addition to utilizing imaging modalities such as ultrasound and computed tomography, are vital in diagnosis of pneumonia mimics.

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Acknowledgements

This manuscript did not utilize any grants, and it has not been presented in abstract form. It does not reflect the views or opinions of the U.S. Government, U.S. Army, U.S. Air Force, Department of Defense, or SAUSHEC residency program.

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  1. Brit Long

    Present address: Department of Emergency Medicine, San Antonio Military Medical Center, 3841 Roger Brooke Dr, Fort Sam Houston, TX, 78234, USA

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  1. Department of Emergency Medicine, San Antonio Military Medical Center, 3841 Roger Brooke Dr, Fort Sam Houston, TX, 78234, USA

    Drew Alan Long

  2. Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA

    Alex Koyfman

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Long, D.A., Long, B. & Koyfman, A. Clinical mimics: an emergency medicine focused review of pneumonia mimics. Intern Emerg Med 13, 539–547 (2018). https://doi.org/10.1007/s11739-018-1840-z

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