A person with chronic obstructive pulmonary disease (COPD) who presents with worsening pulmonary function may have an exacerbation of the COPD or another problem. Accurate diagnosis is essential for correct management.


Conditions which must be distinguished from an exacerbation of COPD:

(1) pneumonia or other pulmonary infection

(2) pneumothorax

(3) aspiration, including GERD

(4) upper airway obstruction

(5) pleural effusion

(6) primary lung cancer

(7) pulmonary embolus

(8) pulmonary edema, including congestive heart failure

(9) exacerbation of asthma

(10) bronchiectasis

(11) lymphangitic metastases to the lung

(12) hypersensitivity pneumonitis

(13) pulmonary fibrosis

(14) cardiac arrhythmia

(15) pulmonary hypertension

(16) radiation pneumonitis

(17) nonpulmonary infection


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