Abstract
Community-acquired pneumonia (CAP) is a common cause of presentation to healthcare facilities. The diagnosis of CAP is usually made in patients with suggestive symptoms, signs, and radiological features. A number of non-infectious conditions, including neoplastic lesions, pulmonary oedema, pulmonary embolism, drug-induced pneumonitis, diffuse alveolar haemorrhage syndromes, cryptogenic organising pneumonia and acute eosinophilic pneumonia, may present in a similar way and mimic CAP. These other conditions are often only thought of after patients that are being treated as CAP fail to respond to therapy. The non-infectious mimics of CAP require early diagnosis and appropriate treatment to decrease patient morbidity and mortality. This article is intended to create an awareness of the non-infectious mimics of CAP and highlight some of the more frequent conditions as well as those that require early diagnosis and treatment to prevent a poor outcome.
Highlights
Community-acquired pneumonia (CAP) is a frequent and treatable cause of persons presenting to healthcare practitioners
In areas with high human immunodeficiency virus infection and tuberculosis prevalence, early testing for both conditions is strongly recommended in patients presenting with the CAP syndrome
As CAP is common, the majority of patients presenting with the CAP syndrome will have CAP and require the early administration of appropriate antibiotics as per regional guidelines
Summary
Community-acquired pneumonia (CAP) is a frequent and treatable cause of persons presenting to healthcare practitioners. A chest radiograph with infiltrates compatible with acute pulmonary infection usually “clinches” the diagnosis of CAP in the attending clinician’s mind [3]. The symptoms and signs of the CAP syndrome are not specific and, even with chest radiograph features compatible with acute pulmonary. Infectious biomarkers such as highly sensitive Creactive protein (hCRP) and procalcitonin (PCT), while suggestive of an infectious aetiology, may be raised in many of the mimics of CAP and do not have sufficient sensitivity or specificity to rule in CAP or to rule out the non- infectious mimics; they can complement the diagnostic process [8]. While there is a wide differential diagnosis for the CAP syndrome, the high incidence of CAP and the relatively low incidence of CAP mimics makes it appropriate
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