Infectious Diseases in Critical Care Medicine

System PE ID findings Noninfectious mimics Diagnostic features

Generalized
lymphadeno-
pathy

1. EBV


2. CMV


3. Rubella


4. Tuberculosis


5. Secondary syphilis


6. Lyme disease


7. Hepatitis A, B


8. Typhoid fever


9. Brucellosis


10. Leptospirosis


11. Histoplasmosis


12. HIV


13. HTLV-1 infection


14. Bartonellosis


15. Mycoplasma


16. Toxoplasmosis


17. Cryptococcosis


18. West Nile virus


19. Measles


20. Scarlet fever


21. Rickettsia(scrub
    typhus, rickettsial
    pox)


22. Dengue


23. Leishmaniasis


24. Lassa fever


25. Monkeypox


26. Chagas’ disease


27. Trypanosomiasis


28. Penicilliosis


29. Melioidosis


30. Glanders

l Lymphoma

l Leukemia

l Rheumatoid arthritis

l SLE

l Drug reaction (phenytoin,

sulfonamides, others)

l Still’s disease

l Multicentric Castleman’s disease

l Kikuchi–Fujimoto disease

l Storage diseases (glycogen,

lipid, lysosomal)

l X-linked lympho-proliferative

disease

l Serum sickness

Culture, serology, biopsy.

Evanescent salmon rash,

elevated ferritin in Still’s

disease.

Tender thyroid 1. Acute suppurative
thyroiditis

l Subacute (de Quervain)

thyroiditis

l Thyroid amyloidosis

l Infarction of a thyroid nodule

Fever> 1028 F suggests

infection. Scanning/

biopsy for others

Hemoptysis 1. Lung abscess

2. Pneumonia


3. Tuberculosis


4. Mycetoma
   (“fungus ball”)


5. Infectious
   tracheobronchitis


6. Bronchiectasis

l Pulmonary neoplasm

(malignant or benign)

Pulmonary embolus/infarction

l Goodpasture’s syndrome

l Idiopathic pulmonary

hemosiderosis

l Wegener’s granulomatosis

l Lupus pneumonitis

l Long trauma/contusion

l Foreign body

l Arteriovenous malformation

l Mitral stenosis

l Pseudohemoptysis

Imaging, serologic tests (ANA,

anti-GBM antibodies,

cANCA), sputum Gram

stain/AFB stain.

Bronchoscopy on occasion.

Inspiratory stridor 1. Epiglottitis

2. Laryngeal TB

l Upper airway foreign body

l Upper airway tumor

Endoscopy, sputum AFB.

Tracheal deviation
(with the patient
sitting up)

1. Toward the lung
   with a lobar
   pneumonia

l Toward the lung with

significant atelectasis

l Deviated by a goiter

l Away from a pleural effusion

Fever favors infection.

Dullness, decreased

fremitus with effusion.

Imaging.

Unilateral or focal
loss of
inspiratory
intercostal
retractions

1. Lobar pneumonia l Pleural effusion
   l Tension pneumothorax

Fever, egophony, increased

fremitus in pneumonia.

Hyperresonance in

pneumothorax.

56 Mishriki