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Last updated: September 10, 2025View editorial policy

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Differential Diagnosis for BOOP (Bronchiolitis Obliterans with Organizing Pneumonia)

When suspecting BOOP, consider the following differential diagnoses:

  • Single most likely diagnosis
    • Idiopathic BOOP: This is the most common form of BOOP, and it should be suspected when there is a history of progressive cough, dyspnea, and radiographic findings of patchy infiltrates without a clear infectious or environmental cause.
  • Other Likely diagnoses
    • Infectious pneumonia: Bacterial, viral, or fungal infections can cause similar symptoms and radiographic findings, and should be considered, especially in immunocompromised patients.
    • Chronic eosinophilic pneumonia: This condition can present with similar symptoms and radiographic findings, and is often associated with eosinophilia.
    • Cryptogenic organizing pneumonia (COP): COP is a type of idiopathic interstitial pneumonia that can present with similar symptoms and radiographic findings.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Lung cancer: Although less likely, lung cancer can present with similar symptoms and radiographic findings, and is a critical diagnosis to consider, especially in patients with a history of smoking.
    • Sarcoidosis: This condition can cause similar symptoms and radiographic findings, and is often associated with other systemic symptoms.
    • Wegener's granulomatosis: This is a rare but potentially life-threatening condition that can cause similar symptoms and radiographic findings.
  • Rare diagnoses
    • Lymphomatoid granulomatosis: This is a rare condition that can cause similar symptoms and radiographic findings, and is often associated with immunocompromised states.
    • Langerhans cell histiocytosis: This is a rare condition that can cause similar symptoms and radiographic findings, and is often associated with smoking and other environmental exposures.
    • Alveolar proteinosis: This is a rare condition that can cause similar symptoms and radiographic findings, and is often associated with immunocompromised states.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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