Echinococcosis differential diagnosis: Difference between revisions
No edit summary |
No edit summary |
||
Line 8: | Line 8: | ||
[[Echinococcus|Echinococcal]] [[cyst]] must be differentiated from other [[diseases]] presenting with similar features of right sided [[abdominal pain]] such as: | [[Echinococcus|Echinococcal]] [[cyst]] must be differentiated from other [[diseases]] presenting with similar features of right sided [[abdominal pain]] such as: | ||
{| class="wikitable" | {| class="wikitable" | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="3" | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | ||
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Causes | |||
! align="center" style="background:#4479BA; color: #FFFFFF; | ! colspan="9" align="center" style="background:#4479BA; color: #FFFFFF;" + |Symptoms | ||
! align="center" style="background:#4479BA; color: #FFFFFF; | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Lab Findings | ||
! align="center" style="background:#4479BA; color: #FFFFFF; | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Imaging Findings | ||
! align="center" style="background:#4479BA; color: #FFFFFF; | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Other Findings | ||
|- | |- | ||
! align="center" style="background:#4479BA; color: #FFFFFF; | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | ||
! align="center" style="background:#4479BA; color: #FFFFFF; | ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Pain | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" rowspan="2" | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Cough | ||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Hepatomegaly | |||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Jaundice | |||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Weight loss | |||
! | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diarrhea | ||
or Dysentry | or Dysentry | ||
! align="center" style="background:#4479BA; color: #FFFFFF; | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Nausea and | ||
vomiting | vomiting | ||
|- | |- | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Abdominal pain | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Abdominal pain | ||
(right upper quadrant pain) | (right upper quadrant pain) | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Pleuritic pain | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Pleuritic pain | ||
|- | |||
|[[hydatid cyst|Echinococcal (hydatid) cyst]] | |||
|[[Echinococcus granulosus]] | |||
| | |||
|✔ | |||
| | |||
|✔ | |||
| | |||
|✔ | |||
([[Obstructive jaundice]]) | |||
|✔ | |||
| | |||
| | |||
|Histology: [[Hydatid cyst]] with three layers: | |||
* The outer pericyst: Corresponds with compressed and fibrosed [[liver]] tissue | |||
* The endocyst: An inner germinal layer | |||
* The ectocyst: A thin, translucent interleaved membrane | |||
|Ultrasound: | |||
* Cystic to solid-appearing pseudotumors | |||
* [[Echinococcus|Water lily sign]] | |||
* [[Calcification|Calcifications]] seen peripherally | |||
| | |||
* Blood or liquid from the ruptured cyst may be coughed up | |||
* [[Pruritis]] | |||
|- | |- | ||
|[[Amoebic liver abscess]] | |[[Amoebic liver abscess]] | ||
Line 45: | Line 68: | ||
|✔ | |✔ | ||
|✔ | |✔ | ||
|[[Hypoalbuminemia]] | |[[Hypoalbuminemia]] | ||
Line 73: | Line 94: | ||
|✔ | |✔ | ||
(acute loss) | (acute loss) | ||
|Pale/dark stool | |||
|✔ | |✔ | ||
|[[Hypoalbuminemia]] | |[[Hypoalbuminemia]] | ||
Line 96: | Line 115: | ||
|✔ | |✔ | ||
|✔/✘ | |✔/✘ | ||
|✔ | |✔ | ||
|✔ | |✔ | ||
Line 103: | Line 121: | ||
|✔ | |✔ | ||
|✔ | |✔ | ||
| | | | ||
|CT and Us findings with four patterns of presentation: | |CT and Us findings with four patterns of presentation: | ||
Line 115: | Line 132: | ||
* [[Candida]] and [[Aspergillus]] are commonly found in the culture of aspirated pus | * [[Candida]] and [[Aspergillus]] are commonly found in the culture of aspirated pus | ||
* Associated with underlying [[malignancy]] or [[DM]] | * Associated with underlying [[malignancy]] or [[DM]] | ||
|- | |- | ||
|Malignancy | |Malignancy | ||
Line 164: | Line 151: | ||
|✔ | |✔ | ||
|✔✔ | |✔✔ | ||
| | |Pale/Chalky stool | ||
|✔✔ | |✔✔ | ||
| | | | ||
* High levels of [[alpha-fetoprotein|AFP]] in serum | * High levels of [[alpha-fetoprotein|AFP]] in serum | ||
Line 180: | Line 165: | ||
* [[Asterixis]] | * [[Asterixis]] | ||
|} | |} | ||
== References == | == References == |
Revision as of 17:42, 21 August 2017
Echinococcosis Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Echinococcosis differential diagnosis On the Web |
American Roentgen Ray Society Images of Echinococcosis differential diagnosis |
Risk calculators and risk factors for Echinococcosis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];
Overview
Cystic echinococcosis must be differentiated from other diseases presenting with right sided abdominal pain such as pyogenic liver abscess and amoebic liver abscess and fungal liver abscess.
Differential Diagnosis
Echinococcal cyst must be differentiated from other diseases presenting with similar features of right sided abdominal pain such as:
Disease | Causes | Symptoms | Lab Findings | Imaging Findings | Other Findings | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Fever | Pain | Cough | Hepatomegaly | Jaundice | Weight loss | Diarrhea
or Dysentry |
Nausea and
vomiting | ||||||
Abdominal pain
(right upper quadrant pain) |
Pleuritic pain | ||||||||||||
Echinococcal (hydatid) cyst | Echinococcus granulosus | ✔ | ✔ | ✔ | ✔ | Histology: Hydatid cyst with three layers:
|
Ultrasound:
|
| |||||
Amoebic liver abscess | Entamoeba histolytica | ✔✔✔ | ✔✔✔ | ✔/✘ | ✔ | ✔✔/✘ | ✔
(late stages) |
✔
(late stages) |
✔ | ✔ | Hypoalbuminemia
(✔) |
|
|
Pyogenic liver abscess | Bacteria
|
✔ | ✔ | ✔✔ | ✔✔ | ✔/✘ | ✔✔✔ | ✔
(acute loss) |
Pale/dark stool | ✔ | Hypoalbuminemia
(✔✔✔) |
Cluster sign |
|
Fungal liver abscess | Candida species Aspergillus species |
✔ | ✔ | ✔/✘ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | CT and Us findings with four patterns of presentation:
|
| |
Malignancy
(hepatocellular carcinoma/metastasis) |
✔ | ✔
(uncommon) |
✔ | ✔ | ✔✔ | Pale/Chalky stool | ✔✔ |
|
Other symptoms: |