Distinguishing Community-Acquired Pneumonia (CAP)

Differentiating Community-Acquired Pneumonia (CAP) from chronic obstructive pulmonary disease (COPD) is a vital step in the diagnosis of the two pulmonary diseases. The requirement for identification is based on the concept of comorbidity, with Pneumonia being a possible cause of COPD. Because both COPD and CAP cause chest tightness, blood-tinged sputum, difficulty speaking, and shortness of breath, it is difficult to distinguish the underlying ailment during flare-ups. Similar symptoms can lead to misdiagnosis and, eventually, incorrect treatment. Clinical symptoms are one of the easiest diagnostic techniques that can be used in the outpatient setting to detect the etiology of flare-ups. Besides the shared signs, COPD is characterized by distinctive indications, which includes high fever, chills body aches, and shaking. On the other hand, CAP is manifested by definitive symptoms such as wheezing, feeling of confusion, irritability, unexplained fatigue that can last for more than a day, and thickening and increased production of sputum (Boixeda et al., 2014).

Another element of differential diagnosis is imaging techniques. A chest X-ray help in confirming non-infectious COPD, where the radiographs show the classic features of emphysema such as increased bronchovascular markings, a flat diaphragm, a narrow heart shadow, and cardiomegaly. CT scan is also employed where high specificity is needed. In CAP, chest images show changes that confirm infiltrative process in the lung parenchyma. Other differential tests include laboratory and blood tests. Biomarkers such as Procalcitonin values and C-reactive protein (CRP) help in distinguishing noninfectious COPD from infectious CAP in exacerbations (Tang, Stratton, & Tang, 2012). A laboratory culture and gram staining may also be used to rule on the role of typical and atypical pathogenic bacteria that causes pneumonia.

References

Boixeda, R., Bacca, S., Elias, L., Capdevila, J. A., Vilà, X., Mauri, M., & Almirall, J. (2014). Pneumonia as comorbidity in chronic obstructive pulmonary disease (COPD). Differences between acute exacerbation of COPD and pneumonia in patients with COPD. Archivos de Bronconeumología (English Edition), 50(12), 514-520.

Tang, Y. W., Stratton, C. W., & Tang, Y. W. (2012). Advanced techniques in diagnostic microbiology (p. 65). New York: Springer.