Differential diagnosis of common respiratory conditions (Guidelines)

Diagnosis	Suggestive features
	Onset in mid-life
COPD (Chronic Obstructive Pulmonary Disease)	Symptoms slowly progressive History of tobacco smoking or exposure to other types of smoke Physical activity Flu vaccination Pneumococcal vaccination
	Onset early in life (often childhood)
Asthma	Symptoms vary widely from day to day Symptoms worse at night/early morning Allergy, rhinitis, and/or eczema also present Family history of asthma Obesity coexistence
Congestive heart failure	Chest X-ray shows dilated heart, pulmonary oedema. Pulmonary function tests indicate volume restriction, not airflow/imitation
Bronchiectasis	Large volumes of purulent sputum Commonly associated with bacterial infection Chest X-ray/CT shows bronchial dilation, bronchial wall thickening.
	Onset all ages
Tuberculosis	Chest X-ray shows lung infiltrate Microbiological confirmation High local prevalence of tuberculosis
	Onset at younger age, non-smokers
Obliterative bronchiolitis	May have history of rheumatoid arthritis or acute fume exposure Seen after lung or bone marrow transplantation CT on expiration shows hypodense areas
Diffuse panbronchiolitis	Predominantly seen in patients of Asian descent Most patients are male and non-smokers Almost all chronic sinusitis Chest/X-ray and high-resolution computed tomography show diffuse small centrilobular nodular opacities and hyperinflation

These features tend to be characteristic of the respective diseases, but are not mandatory. For example, a person who has never smoked may develop COPD (especially in the developing world where other risk factors may be more important than cigarette smoking); asthma may develop in adult and even in elderly patients.

Last reviewed: 12/03/2021

Next review date: 12/03/2024

Author(s): Respiratory department.

Version: 1

Approved By: TAM subgroup of the ADTC

Reviewer name(s): M Duffy, Advanced Practice Respiratory Nurse.

Document Id: TAM364

Differential diagnosis of common respiratory conditions (Guidelines)

Diagnosis

Suggestive features

Editorial Information