Clinical mimics: an emergency medicine focused review of pneumonia mimics

Pneumonia is a common cause of morbidity and mortality in adults in the United States. While pneumonia classically presents with a fever, cough, and shortness of breath, the presentation can vary widely in adults. This review evaluates history and physical examination findings of pneumonia and several conditions that mimic pneumonia. Pneumonia is a potentially deadly disease. History and examination findings are variable in pneumonia, and many conditions mimic pneumonia. These conditions include pulmonary embolism, diffuse interstitial lung disease, endocarditis, vasculitis, diffuse alveolar hemorrhage, acute decompensated heart failure, tuberculosis, lung cancer, and acute respiratory distress syndrome. Emergency clinicians should assess the patient while resuscitation occurs. Early antibiotics and the diagnosis of pneumonia can improve outcomes. Key historical and physical examination findings may lead the clinician to consider other conditions that require immediate management. Using clinical evaluation and adjunctive imaging, these conditions can be diagnosed and treated. Knowledge of pneumonia mimics is vital for the care of patients with respiratory complaints. Pneumonia is common and may be deadly, and emergency clinicians must differentiate conditions that mimic pneumonia. Rapid evaluation and management may alleviate morbidity and mortality for each of these conditions. The history and physical examination, in addition to utilizing imaging modalities such as ultrasound and computed tomography, are vital in diagnosis of pneumonia mimics.