
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Bronchiectasis differential diagnosis
Introduction

Overview
Overview
Bronchiectasis must be differentiated from other diseases that cause dyspnea and cough, such as COPD, asthma, pneumonia, tuberculosis, chronic sinusitis, lung cancer, postnasal drip and inhaled foreign body.
Bronchiectasis Differential Diagnosis
Bronchiectasis Differential Diagnosis
The following table lists the most common differential diagnoses of bronchiectasis based on chronic cough:[1][2]
| Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical exam | ||||||||||||||
| Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
| Respiratory | Upper airway diseases | Laryngopharyngeal reflux_American_Academy_of_Otolaryngology-Head_and_Neck_Surgery-3|[3][4] | Chronic |
|
+ | β | β | β | + |
|
|
|
| ||
| Rhinosinusitis[5][6] | Acute, subacute, chronic, recurrent | + | β | β | + | + |
|
|
|
|
| ||||
| Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
| Symptoms | Physical exam | ||||||||||||||
| Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
| Respiratory | Lower airway | Asthma[7] | Chronic |
|
+ Clear mucoid or yellow sputum | β | β | β | + |
|
|
|
|
| |
| Chronic Bronchitis[8][9] | Chronic |
|
+ Clear sputum | β | β | + | + |
|
|
|
| ||||
| Nonβasthmatic eosinophilic bronchitis[10][11] | Chronic |
|
+ Eosinophilic sputum | β | β | β | + |
|
|
|
| ||||
| Bronchiectasis[12] | Chronic |
|
+ Mucopurulent sputum | + | β | β | + |
|
|
|
| ||||
| Emphysema [13] | Chronic |
|
+ Mucoid or purulent sputum | β | β | + | + |
|
|
|
|
| |||
| Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
| Symptoms | Physical exam | ||||||||||||||
| Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
| Respiratory | Parenchyma | Pneumoconioses[14][15] | Acute, Chronic |
|
β | β | + | + | + |
|
|
||||
| Lung cancer[16][17] | Chronic |
|
+ | + | + | +/β | + | The following investigations may be helpful: |
|
|
| ||||
| Interstitial lung disease[18][19] | Chronic |
|
β | + | + | β | + |
|
The following investigations may be helpful: |
|
|
| |||
| Tuberculosis (TB)[20][21] | Chronic |
|
+ | + | + | + | + |
|
|
|
|
| |||
| Cystic fibrosis (CF)[22][23] | Chronic |
|
+ | β | + | +/β | + |
|
|
| |||||
| Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
| Symptoms | Physical exam | ||||||||||||||
| Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
| [[[Heart|Cardiac]] | Mitral Stenosis[24][25] | Chronic |
|
+ Pink frothy | + | β | β | + |
|
|
|
|
|||
| Pulmonary hypertension[26][27] | Chronic |
|
β | + | + | β | + | The following investigations may be helpful: |
|
|
| ||||
| Gastrointestinal | Gastroesophageal reflux[28][29] | Chronic |
|
+ | β | + | β | + |
|
|
|
|
ββ | ||
| Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
| Symptoms | Physical exam | ||||||||||||||
| Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
| Autoimmune | Goodpasture syndrome[30][31] | Chronic |
|
β | + | β | β | + | The following investigations may be helpful:
|
|
|
||||
| Wegener’s disease (GPA) [32][33] | Chronic |
|
+ | + | + | + | + | The following investigations may be helpful: |
|
|
|
| |||
| Sarcoidosis[34][35] | Chronic |
|
β | β | + | + | + |
|
The following investigations may be helpful: |
|
|
||||
| Microscopic polyangitis (MPA)[36] | Chronic |
|
+ | + | + | + | + | The following investigations may be helpful:
|
|
|
|
| |||
| ChurgβStrauss[37][38] | Chronic |
|
+ | + | + | + | + |
|
|
|
|
||||
Cough
Cough
The differential diagnosis according to cough for bronchiectasis is shown in the table below:
| Organ system | Diseases | Clinical manifestations | Diagnosis | Other features | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical exam | ||||||||||||||
| Onset | Duration | Productive cough | Hemoptysis | Weight lost | Fever | Dyspnea | Ascultation | Lab findings | Imaging | PFT | Gold standard | ||||
| Respiratory | Upper airway diseases | Epiglottitis[39][40] | Abrupt or acute |
|
– | – | – | β | β |
|
|
|
|
| |
| Croup[41] | Acute |
|
β | – | – | – | β |
|
|
|
|
| |||
| Pertussis[42]_Whooping_Cough_|_Clinical_|_Information_|_CDC-43|[43] | Acute |
|
β Whooping sound | – | β | – | β |
|
|
|
|
| |||
| Laryngopharyngeal reflux_American_Academy_of_Otolaryngology-Head_and_Neck_Surgery-3|[3][4] | Chronic |
|
β | – | – | – | β |
|
|
|
| ||||
| Common Cold[44] | Acute |
|
β | – | – | β | – |
|
|
|
|
||||
| Seasonal Influenza [45] | Acute |
|
– | – | – | β | β |
|
|
|
| ||||
| Rhinosinusitis[5][6] | Acute, subacute, chronic, recurrent | β | – | – | β | β |
|
|
|
|
| ||||
| Lower airway | Asthma[7] | Chronic |
|
β Clear mucoid or yellow sputum | – | – | – | β |
|
|
|
|
| ||
| Acute Bronchitis[46] | Acute |
|
β | – | – | – | β |
|
|
|
|
| |||
| Chronic Bronchitis[8][9] | Chronic |
|
β Clear sputum | – | – | β | β |
|
|
|
| ||||
| Non-asthmatic eosinophilic bronchitis[10][11] | Chronic |
|
β Eosinophilic sputum | – | – | β |
|
|
|
| |||||
| Bronchiectasis[12] | Chronic |
|
β Mucopurulent sputum | β | – | β |
|
|
|
| |||||
| Emphysema [13] | Chronic |
|
β Mucoid or purulent sputum | – | – | β | β |
|
|
|
|
| |||
| Foreing body aspiration[47][48][49] | Acute |
|
β | β | – | β | β |
|
|
|
|
| |||
| Bronchiolitis[50][51] | Acute |
|
β | – | β | β |
|
|
|
|
| ||||
| Parenchyma | Pneumonia[52][53] | Acute |
|
β Mucopurulent sputum | – | – | β | β |
|
|
|
|
|||
| Pneumoconioses[14][15] | Acute, Chronic |
|
– | – | β | β | β |
|
|
||||||
| Lung cancer[16][17] | Chronic |
|
β | β | β | – | β |
|
|
| |||||
| Interstitial lung disease[18][19] | Chronic |
|
– | β | β | – | β |
|
|
|
|
| |||
| Tuberculosis (TB)[20][21] | Chronic |
|
β | β | β | β | β |
|
|
|
|
| |||
| Cystic fibrosis (CF)[22][23] | Chronic |
|
β | – | β | β |
|
|
| ||||||
| Cardiac | Cardiogenic pulmonary edema[54][55] | Acute |
|
β Pink frothy, liquid | – | β | – | β |
|
|
|
|
| ||
| Mitral Stenosis[24][25] | Chronic |
|
β Pink frothy | β | – | – | β |
|
|
|
|
||||
| Pulmonary hypertension[26][27] | Chronic |
|
– | β | β | – | β |
|
|
| |||||
| Gastrointestinal | Gastroesophageal reflux[28][29] | Chronic |
|
β | – | β | – | β |
|
|
|
|
— | ||
| Autoinmune | Goodpasture syndrome[30][31] | Chronic |
|
– | β | – | – | β |
|
|
|
||||
| Wegener’s disease (GPA) [32][33] | Chronic |
|
β | β | β | β | β |
|
|
|
| ||||
| Sarcoidosis[34][35] | Chronic |
|
– | – | β | β | β |
|
|
|
|||||
| Microscopic polyangitis (MPA)[36] | Chronic |
|
β | β | β | β | β |
|
|
|
|
| |||
| Churg-Strauss[37][38] | Chronic |
|
β | β | β | β | β |
|
|
|
|
||||
| Medication | ACE inhibitors[56][57] | Acute (depend on the medication) |
|
– | – | – | – | β |
|
|
|
|
| ||
Features that may suggest bronchiectasis in a patient presenting with chronic respiratory symptoms
- Digital clubbing
- Lack of a significant smoking history (if COPD is suspected)
- History of recurrent and/or severe pneumonia or tuberculosis
- Presence of either Aspergillus, atypical/nontuberculous Mycobacteria, Pseudomonas aeruginosa, Escherichia coli, or Klebsiella pneumoniae in the sputum
References
References
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βββ
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Saarah T. Alkhairy, M.D.
