African trypanosomiasis differential diagnosis: Difference between revisions
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{{CMG}} ; {{AE}} {{ADG}} | {{CMG}} ; {{AE}} {{ADG}} | ||
==Overview== | ==Overview== | ||
The hemo-lymphatic stage of [[African trypanosomiasis]] presents with a [[rash]], [[fever]], and [[anemia]] and must be differentiated from other diseases such as [[brucellosis]], [[typhoid fever]], [[malaria]], [[tuberculosis]], [[lymphoma]], [[dengue]], and [[leptospirosis]]. The most prominent symptoms in the [[neurological]] stage of [[African trypanosomiasis]] are [[Altered mental status|mental status changes]] and [[sleep disturbances]], so [[Differential diagnosis|differential diagnoses]] include [[CNS]] [[TB|tuberculosis]], [[meningitis]], and [[HIV]]-related [[Opportunistic infection|opportunistic infections]], including [[Cryptococcal Meningitis|cryptococcal meningitis]]. | The hemo-lymphatic stage of [[African trypanosomiasis]] presents with a [[rash]], [[fever]], and [[anemia]] and must be differentiated from other diseases such as [[brucellosis]], [[typhoid fever]], [[malaria]], [[tuberculosis]], [[lymphoma]], [[dengue]], and [[leptospirosis]]. The most prominent [[Symptom|symptoms]] in the [[neurological]] stage of [[African trypanosomiasis]] are [[Altered mental status|mental status changes]] and [[sleep disturbances]], so [[Differential diagnosis|differential diagnoses]] include [[CNS]] [[TB|tuberculosis]], [[meningitis]], and [[HIV]]-related [[Opportunistic infection|opportunistic infections]], including [[Cryptococcal Meningitis|cryptococcal meningitis]]. | ||
==Differentiating African trypanosomiasis from other diseases== | ==Differentiating African trypanosomiasis from other diseases== | ||
*The hemo-lymphatic stage of [[African trypanosomiasis]] presents with a [[rash]], [[fever]], and [[anemia]] and must be differentiated from other diseases such as [[brucellosis]], [[typhoid fever]], [[malaria]], [[tuberculosis]], [[lymphoma]], [[dengue]], and [[leptospirosis]]. | *The hemo-lymphatic stage of [[African trypanosomiasis]] presents with a [[rash]], [[fever]], and [[anemia]] and must be differentiated from other diseases such as [[brucellosis]], [[typhoid fever]], [[malaria]], [[tuberculosis]], [[lymphoma]], [[dengue]], and [[leptospirosis]]. | ||
*The most prominent symptoms in neurological stage of [[African trypanosomiasis]] are [[Altered mental status|mental status changes]] and [[sleep disturbances]]. [[Differential diagnosis|Differential diagnoses]] includes [[CNS]] [[TB|tuberculsosis]], [[meningitis]], and [[HIV]]-related [[Opportunistic infection|opportunistic infections]], including [[Cryptococcal Meningitis|cryptococcal meningitis]].<ref name="pmid1593042322">{{cite journal|author=Pappas G, Akritidis N, Bosilkovski M, Tsianos E|title=Brucellosis.|journal=N Engl J Med|year=2005|volume=352|issue=22|pages=2325-36|pmid=15930423|doi=10.1056/NEJMra050570|pmc=|url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15930423}}</ref><ref>Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on January,2017</ref><ref name="pmid754636422">{{cite journal|year=1995|title=Brucellosis: current epidemiology, diagnosis, and management.|url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7546364|journal=Curr Clin Top Infect Dis|volume=15|issue=|pages=115-28|doi=|pmc=|pmid=7546364|author=Young EJ}}</ref><ref name="enf22">Enfermedades infecciosas: Brucelosis -Diagnóstico de Brucelosis,Guia para el Equipo de Salud. Ministerio de Salud-Argentina. http://www.msal.gob.ar/images/stories/bes/graficos/0000000304cnt-guia-medica-brucelosis.pdf. Accessed on February 2, 2016</ref> | *The most prominent symptoms in neurological stage of [[African trypanosomiasis]] are [[Altered mental status|mental status changes]] and [[sleep disturbances]]. [[Differential diagnosis|Differential diagnoses]] includes [[CNS]] [[TB|tuberculsosis]], [[meningitis]], and [[HIV]]-related [[Opportunistic infection|opportunistic infections]], including [[Cryptococcal Meningitis|cryptococcal meningitis]].<ref name="pmid1593042322">{{cite journal|author=Pappas G, Akritidis N, Bosilkovski M, Tsianos E|title=Brucellosis.|journal=N Engl J Med|year=2005|volume=352|issue=22|pages=2325-36|pmid=15930423|doi=10.1056/NEJMra050570|pmc=|url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15930423}}</ref><ref>Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on January,2017</ref><ref name="pmid754636422">{{cite journal|year=1995|title=Brucellosis: current epidemiology, diagnosis, and management.|url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7546364|journal=Curr Clin Top Infect Dis|volume=15|issue=|pages=115-28|doi=|pmc=|pmid=7546364|author=Young EJ}}</ref><ref name="enf22">Enfermedades infecciosas: Brucelosis -Diagnóstico de Brucelosis,Guia para el Equipo de Salud. Ministerio de Salud-Argentina. http://www.msal.gob.ar/images/stories/bes/graficos/0000000304cnt-guia-medica-brucelosis.pdf. Accessed on February 2, 2016</ref> | ||
'''The table below summarizes the findings that differentiate African trypanosomiasis from other conditions that cause fever, rash and altered mental status''' | '''The table below summarizes the findings that differentiate African trypanosomiasis from other conditions that cause [[fever]], rash and [[altered mental status]]'''<small> | ||
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!Differential diagnosis of African trypanosomiasis | !Differential diagnosis of African trypanosomiasis | ||
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|Constant fatigue | |Constant fatigue | ||
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==References== | ==References== | ||
Revision as of 05:40, 17 August 2017
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African trypanosomiasis differential diagnosis On the Web |
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Risk calculators and risk factors for African trypanosomiasis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
The hemo-lymphatic stage of African trypanosomiasis presents with a rash, fever, and anemia and must be differentiated from other diseases such as brucellosis, typhoid fever, malaria, tuberculosis, lymphoma, dengue, and leptospirosis. The most prominent symptoms in the neurological stage of African trypanosomiasis are mental status changes and sleep disturbances, so differential diagnoses include CNS tuberculosis, meningitis, and HIV-related opportunistic infections, including cryptococcal meningitis.
Differentiating African trypanosomiasis from other diseases
- The hemo-lymphatic stage of African trypanosomiasis presents with a rash, fever, and anemia and must be differentiated from other diseases such as brucellosis, typhoid fever, malaria, tuberculosis, lymphoma, dengue, and leptospirosis.
- The most prominent symptoms in neurological stage of African trypanosomiasis are mental status changes and sleep disturbances. Differential diagnoses includes CNS tuberculsosis, meningitis, and HIV-related opportunistic infections, including cryptococcal meningitis.[1][2][3][4]
The table below summarizes the findings that differentiate African trypanosomiasis from other conditions that cause fever, rash and altered mental status
| Differential diagnosis of African trypanosomiasis | Symptoms | Signs | Diagnosis | Additional Findings | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Fever | Rash | Diarrhea | Abdominal pain | Weight loss | Painful lymphadenopathy | Hepatosplenomegaly | Arthritis | Lab Findings | ||
| Brucellosis | + | + | - | + | + | + | + | + | Relative lymphocytosis |
Night sweats, often with characteristic smell, likened to wet hay |
| Typhoid fever | + | + | - | + | - | - | + | + | Decreased hemoglobin | Incremental increase in temperature initially and then sustained fever as high as 40°C (104°F) |
| Malaria | + | - | + | + | - | - | + | + | Microcytosis,
elevated LDH |
"Tertian" fever: paroxysms occur every second day |
| Tuberculosis | + | + | - | + | + | + | - | + | Mild normocytic anemia, hyponatremia, and | Night sweats, constant fatigue |
| Lymphoma | + | - | - | + | + | - | + | - | Increase ESR, increased LDH | Night sweats, constant fatigue |
| Mumps | + | - | - | - | - | + | - | - | Relative lymphocytosis, serum amylase elevated | Parotid swelling/tenderness |
| HIV | - | - | - | + | + | + | - | + | Constant fatigue | |
References
- ↑ Pappas G, Akritidis N, Bosilkovski M, Tsianos E (2005). "Brucellosis". N Engl J Med. 352 (22): 2325–36. doi:10.1056/NEJMra050570. PMID 15930423.
- ↑ Brucellosis "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on January,2017
- ↑ Young EJ (1995). "Brucellosis: current epidemiology, diagnosis, and management". Curr Clin Top Infect Dis. 15: 115–28. PMID 7546364.
- ↑ Enfermedades infecciosas: Brucelosis -Diagnóstico de Brucelosis,Guia para el Equipo de Salud. Ministerio de Salud-Argentina. http://www.msal.gob.ar/images/stories/bes/graficos/0000000304cnt-guia-medica-brucelosis.pdf. Accessed on February 2, 2016