Differential Diagnosis for Patchy Lung Infiltrate and Pleural Effusion
Single Most Likely Diagnosis
- Pneumonia: This is the most common cause of patchy lung infiltrates and can be associated with pleural effusion, especially if the pneumonia is bacterial or due to certain types of organisms like Streptococcus pneumoniae or Klebsiella pneumoniae.
Other Likely Diagnoses
- Pulmonary Embolism: While typically presenting with more acute symptoms, pulmonary embolism can cause patchy infiltrates if there is associated pulmonary infarction and can also lead to pleural effusion.
- Acute Respiratory Distress Syndrome (ARDS): This condition can result from various causes, including infection, trauma, and shock, leading to bilateral lung infiltrates and can be associated with pleural effusions.
- Lung Cancer: Especially if the patient has a history of smoking or other risk factors, lung cancer can cause both lung infiltrates and pleural effusions, particularly if there is metastasis to the pleura.
Do Not Miss Diagnoses
- Tuberculosis (TB): Although less common in some regions, TB can present with patchy lung infiltrates and pleural effusion, and missing this diagnosis can have significant consequences due to its infectious nature and the need for specific treatment.
- Pulmonary Vasculitis (e.g., Wegener's Granulomatosis): These conditions can cause a wide range of pulmonary symptoms, including infiltrates and effusions, and are critical to diagnose due to their potential for severe morbidity and mortality if not treated promptly.
- Sarcoidosis: While often presenting with more chronic symptoms, sarcoidosis can cause lung infiltrates and pleural effusions, and its diagnosis is crucial for appropriate management.
Rare Diagnoses
- Lymphangitic Carcinomatosis: A rare condition where cancer spreads to the lymphatic vessels of the lungs, causing infiltrates and potentially pleural effusions.
- Eosinophilic Pneumonia: A group of diseases characterized by an accumulation of eosinophils in the lungs, which can present with infiltrates and sometimes pleural effusions.
- Idiopathic Pulmonary Hemosiderosis: A rare condition characterized by recurrent episodes of diffuse alveolar hemorrhage, which can cause lung infiltrates and potentially pleural effusions.