Differential Diagnosis for Patchy Ground Glass
- Single most likely diagnosis
- Pneumonia: This is often the first consideration for patchy ground glass opacities on imaging, as it can represent an infectious or inflammatory process affecting the lungs.
- Other Likely diagnoses
- Pulmonary edema: This condition, which involves fluid accumulation in the lungs, can also present with ground glass opacities, especially if it's due to heart failure or other causes of fluid overload.
- Acute respiratory distress syndrome (ARDS): While more diffuse, ARDS can initially present with patchy ground glass opacities and is a critical condition to consider, especially in critically ill patients.
- Interstitial lung disease (ILD): Certain types of ILD, such as nonspecific interstitial pneumonia (NSIP), can present with ground glass opacities, although these are often more diffuse and accompanied by other findings.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary embolism with infarction: While not typically the first diagnosis that comes to mind with ground glass opacities, pulmonary infarction from an embolism can present in this way, and missing this diagnosis can be fatal.
- Pneumocystis jirovecii pneumonia (PCP): Especially in immunocompromised patients, PCP can present with ground glass opacities and is a critical diagnosis not to miss due to its high mortality if untreated.
- Rare diagnoses
- Alveolar proteinosis: A rare condition characterized by the accumulation of protein and phospholipids within the alveoli, which can present with ground glass opacities on imaging.
- Lymphangitic carcinomatosis: Metastatic disease to the lymphatics of the lung can cause ground glass opacities, although this is less common and usually accompanied by other signs of malignancy.
- Eosinophilic pneumonia: This rare condition, characterized by an accumulation of eosinophils in the lungs, can present with ground glass opacities, especially in the context of parasitic infections or drug reactions.