Acute bloody diarrhea differential diagnosis: Difference between revisions

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Created page with "__NOTOC__ {{CMG}}; {{AE}} {{SSH}} ==Differential Diagnosis of Acute Bloody Diarrhea from other diseases== '''The following table outlines the major differential diagnoses of..."
 
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__NOTOC__
__NOTOC__
{{CMG}}; {{AE}} {{SSH}}
{{CMG}}; {{AE}} {{SSH}}


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| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Abdominal [[Computed tomography|CT scan]]
*Abdominal [[Computed tomography|CT scan]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Lactose intolerance]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Abdominal tenderness ]]
* [[Abdominal distention]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Lactose tolerance test
* Genetic testing
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Headache]]
* [[Vertigo]]
* [[Memory impairment]]
* [[Lethargy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Reduction of lactase enzyme activity or inability to produce persistent [[lactase]]
* Congenital [[lactase deficiency]]
* Secondary lactose malabsorption
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Small bowel]] [[biopsy]] 
* Lactose breath hydrogen test
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Tropical sprue]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Angular [[stomatitis]]
* Oral mucosal lesion
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Fat soluble vitamins]] deficiency
* [[Vitamin B12 deficiency]]
* [[Folate deficiency]]
* [[Hypokalemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Myalgia]]
*[[Neuropathy]]
*[[Edema]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* ''[[Escherichia coli]]''
* ''[[Klebsiella pneumoniae]]''
* ''[[Enterobacter cloacae]]''
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Diagnosis of exclusion
|-
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Pseudomembranous enterocolitis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Pseudomembranous enterocolitis]]
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| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Salmonella|''Salmonella'']]
*[[Salmonella|''Salmonella'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Shigellosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
* [[Abdominal distention]]
* Hyperactive [[Stomach rumble|bowel sounds]]
* Diffuse [[abdominal tenderness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[C-reactive protein|CRP]]
*Elevated [[Erythrocyte sedimentation rate|ESR]]
*[[Hyponatremia]]
* [[Hypoglycemia]]
* [[Azotemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Headache]]
* [[Lethargy]]
* [[Seizures]]
* [[Delirium]]
* [[Post-infectious arthritis|Post–infectious arthritis]]
* [[Myocarditis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Shigella|''Shigella'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
*[[Stool culture]]
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! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
|-
! rowspan="5" style="background:#DCDCDC;" align="center" |[[Escherichia coli enteritis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Shigellosis]]
| style="background:#DCDCDC;" align="center" |[[ETEC|'''ETEC''']]
([[Traveler's diarrhea]])
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*Diffuse [[abdominal tenderness]]
* [[Abdominal distention]]
* Hyperactive [[Stomach rumble|bowel sounds]]
* Diffuse [[abdominal tenderness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[C-reactive protein|CRP]]
*Elevated [[Erythrocyte sedimentation rate|ESR]]
*[[Hyponatremia]]
* [[Hypoglycemia]]
* [[Azotemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Headache]]
* [[Lethargy]]
* [[Seizures]]
* [[Delirium]]
* [[Post-infectious arthritis|Post–infectious arthritis]]
* [[Myocarditis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Escherichia coli|''Enterotoxigenic escherichia coli'']]
*[[Shigella|''Shigella'']]
*[[Enterotoxin|Enterotoxins]]:
**Heat–labile [[enterotoxin]] (LT)
**Heat–stable [[enterotoxin]] (ST)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
*[[Stool culture]]
|-
|-
! rowspan="4" |[[Escherichia coli enteritis]]
| style="background:#DCDCDC;" align="center" |[[EPEC|'''EPEC''']]
| style="background:#DCDCDC;" align="center" |[[EPEC|'''EPEC''']]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
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| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Yersinia enterocolitica|''Yersinia enterocolitica'']]
*[[Yersinia enterocolitica|''Yersinia enterocolitica'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Vibrio cholerae|Vibrio cholera]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[stool culture]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Azotemia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Severe [[dehydration]]
*Decreased [[Turgor|skin turgor]]
*[[Oliguria]]
*[[Renal insufficiency|Renal failure]]
*[[Cramp|Muscle cramps]]
*[[Seizure]]
*[[Somnolence]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Cholera toxin]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Stool culture]]
*[[Stool culture]]
Line 804: Line 639:
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Norovirus]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*[[Abdominal distension|Abdominal distention]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive stool reverse–transcriptase [[polymerase chain reaction]] (RT–PCR)
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Myalgia]]
*[[Headache]] 
*[[Seizure]] 
*[[Encephalopathy]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Norovirus|''Norovirus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Rotavirus]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
* Hyperactive [[Stomach rumble|bowel sounds]]
* Diffuse [[abdominal tenderness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[blood urea nitrogen]]
*[[Hyperchloremic acidosis]]
*[[Hypocalcemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Necrotizing enterocolitis]]
*[[Intussusception]] 
*[[Biliary atresia]]
*[[Central nervous system]] involvement
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Rotavirus|''Rotavirus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Stool immune–based assays
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Echovirus]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*[[Abdominal distension|Abdominal distention]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hepatic failure|Liver failure]]
*[[Myocarditis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Echovirus|''Echovirus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Adenoviridae|Adenovirus]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*[[Abdominal distension|Abdominal distention]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Viral antigen assay
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Respiratory disease]]
*[[Hyperkeratosis|Follicular]] [[conjunctivitis]]
*Epidemic [[keratoconjunctivitis]]
*[[Hepatitis]] 
*[[Urethritis]] 
*[[Myocarditis]] 
*[[Meningitis]] 
*[[Bacteremia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Adenoviridae|''Adenovirus'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[CMV colitis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[CMV colitis]]
Line 968: Line 675:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Quantitative polymerase chain reaction|Quantitative PCR]] tests 
*[[Quantitative polymerase chain reaction|Quantitative PCR]] tests 
|-
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Entamoeba histolytica]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Entamoeba histolytica]]
Line 1,029: Line 708:
*Antigen testing
*Antigen testing
*Serology 
*Serology 
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Microsporidia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*[[Abdominal distension|Abdominal distention]]
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive stool microscopy
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Decreased [[CD4]] count
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Malabsorption]]
*[[Keratitis]] 
*[[Seizure]]
*[[Myositis]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Microsporidia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Antigen detection assays
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Isospora]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Abdominal distension|Abdominal distention]]
*Diffuse [[Tenderness (medicine)|abdominal tenderness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive stool microscopy
*Positive [[fecal fat]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[Eosinophil granulocyte|eosinophils]] 
*[[Hypokalemia]]
*Increased [[creatinine]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Chronic illness in [[Immunodeficiency|immunocompromised]] patients
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Isospora|''Isospora'']]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Detecting oocysts in the feces
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[VIPoma]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
* [[Abdominal distention]]
* Abdominal [[RUQ]] [[tenderness]]
* [[Nausea]]
* [[Vomiting]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated [[VIP]] level
*[[Hypokalemia]]
*[[Hypochlorhydria]] or [[achlorhydria]]
*Low osmotic gap (<50 mOsm/kg)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Rash]]
* [[Facial flushing]]
* [[Dehydration]]
* [[Lethargy]]
* [[Muscle weakness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Primary secretory tumor
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Blood [[VIP]] levels
* Followed by imaging
|-
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |Medications
* [[ACE inhibitor|ACE inhibitors]]
* [[Digoxin]]
* [[Cephalosporin|Cephalosporins]]
* [[Statins]]
* [[Thiazide|Thiazide diuretics]]
* [[Triptans]]
* [[Lactulose]]
* [[HIV AIDS medical therapy|Anti retroviral agents]]
* [[Chemotherapy|Chemotherapeutic agents]]
* [[Antifungal drug|Antifungals]]
* [[Magnesium]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |±
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*[[Abdominal distention]]
*[[Dehydration]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/↓
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Elevated plasma level of drug
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Inflammation]]
*[[Pseudomembranous enterocolitis|Pseudomembranous colitis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical evaluation after discontinuation of the drugs
|-
! colspan="2" style="background:#DCDCDC;" align="center" |Factitious diarrhea
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*[[Abdominal distention]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑/↓
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Hypokalemia]] 
*[[Metabolic alkalosis]]
*[[Hypermagnesemia]] 
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Malabsorption]]
*[[Lethargy]]
*[[Generalized weakness]]
*[[Acute kidney injury|Acute renal failure]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Medication|Medications]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical evaluation after discontinuation of the drugs
|-
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Organophosphate poisoning]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*[[Saliva|Salivation]]
*[[Nausea and vomiting|Vomiting]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Reduced RBC acetylcholinesterase
*Plasma [[cholinesterase]] activity
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Dysautonomia|Autonomic dysfunction]]
*Motor deficit
*Sensory deficit
*[[Bronchospasm]]
*[[Urination]]
*[[Miosis]]
*[[Bradycardia]]
*[[Lacrimation]]
*[[Sweating]]
*[[Cardiac arrhythmia|Cardiac arrhythmias]]
*[[Acute kidney injury|Acute renal injury]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Neurotoxin|Neurotoxins]] bind to [[ACHE|acetylcholinesterase]] (AChE)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Opium withdrawal]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="Left" |
*Hyperactive [[Stomach rumble|bowel sounds]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |–
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Azotemia]]
*[[Hypokalemia]]
*[[Metabolic alkalosis]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Dysphoria]] 
*[[Agitation (emotion)|Restlessness]]
*[[Perspiration|Sweating]]
*[[Rhinorrhea]]
*[[Tears|Lacrimation]]
*[[Myalgia]]
*[[Arthralgia]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Opium|Opium withdrawal]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis following [[opium withdrawal]]
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Short bowel syndrome]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | +
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Abdominal distension|Abdominal distention]]
* [[Tenderness (medicine)|Abdominal tenderness]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | –
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Positive [[fecal fat]]
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Nl
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |↓
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ↑
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* [[Hypoalbuminemia]]
* High level of [[Acute phase protein|acute phase reactant]]
* Abnormal [[liver function tests]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Prior [[Intestine|intestinal]] surgery
* [[Malabsorption]]
* [[Crohn's disease]]
* [[Cancer|Malignancy]]
* Peripheral [[edema]]
* [[Muscle atrophy]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* Surgical [[bowel resection]]
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Clinical diagnosis following [[bowel resection]]
|-
|-
! colspan="2" style="background:#DCDCDC;" align="center" |[[Radiation enteropathy|Radiation enteritis]]
! colspan="2" style="background:#DCDCDC;" align="center" |[[Radiation enteropathy|Radiation enteritis]]
Line 1,408: Line 740:
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Segmental bowel [[inflammation]] on [[endoscopy]] or [[colonoscopy]]
*Segmental bowel [[inflammation]] on [[endoscopy]] or [[colonoscopy]]
|-
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Fever
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal pain
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |GI signs
! colspan="5" style="background:#4479BA; color: #FFFFFF;" align="center" |Stool exam
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |CBC
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Other lab findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Extra intestinal findings
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Cause/Pathogenesis
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard diagnosis
|-
! style="background:#4479BA; color: #FFFFFF;" align="center" |Acute
! style="background:#4479BA; color: #FFFFFF;" align="center" |Chronic
! style="background:#4479BA; color: #FFFFFF;" align="center" |Watery
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bloody
! style="background:#4479BA; color: #FFFFFF;" align="center" |Fatty
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |RBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ova/Parasite
! style="background:#4479BA; color: #FFFFFF;" align="center" |Osmotic gap
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |WBC
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hgb
! style="background:#4479BA; color: #FFFFFF;" align="center" |Plt
|- }
|- }
|}
|}

Revision as of 20:06, 21 December 2017


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Differential Diagnosis of Acute Bloody Diarrhea from other diseases

The following table outlines the major differential diagnoses of acute bloody diarrhea.[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]

Abbreviations: GI: Gastrointestinal, CBC: Complete blood count, WBC: White blood cell, RBC: Red blood cell, Plt: Platelet, Hgb: Hemoglobin, ESR: Erythrocyte sedimentation rate, CRP: C–reactive protein, IgE: Immunoglobulin E, IgA: Immunoglobulin A, ETEC: Escherichia coli enteritis, EPEC: Enteropathogenic Escherichia coli, EIEC: Enteroinvasive Escherichia coli, EHEC: Enterohemorrhagic Escherichia coli, EAEC: Enteroaggregative Escherichia coli, Nl: Normal, ASCA: Anti saccharomyces cerevisiae antibodies, ANCA: Anti–neutrophil cytoplasmic antibody, DNA: Deoxyribonucleic acid, CFTR: Cystic fibrosis transmembrane conductance regulator, SLC10A2: Solute carrier family 10 member 2, SeHCAT: Selenium homocholic acid taurine or tauroselcholic acid, IEL: Intraepithelial lymphocytes, MRCP: Magnetic resonance cholangiopancreatography, ANA: Antinuclear antibodies, AMA: Anti-mitochondrial antibody, LDH: Lactate dehydrogenase, CPK: Creatine phosphokinasePCR: Polymerase chain reaction, ELISA: Enzyme–linked immunosorbent assay, LT: Heat–labile enterotoxin, ST: Heat–stable enterotoxin, RT-PCR: Reverse–transcriptase polymerase chain reaction, CD4: Cluster of differentiation 4, HIV: Human immunodeficiency virus, RUQ: Right-upper quadrant, VIP: Vasoactive intestinal peptide, GI: Gastrointestinal, FAP: Familial adenomatous polyposis, HNPCC: Hereditary nonpolyposis colorectal cancer, MTP: Microsomal triglyceride transfer protein, Scl‑70: Anti–topoisomerase I, TSH: Thyroid-stimulating hormone, T4: Thyroxine, T3: Triiodothyronine, DTR: Deep tendon reflex, RNA: Ribonucleic acid

Cause Clinical manifestation Lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Symptoms GI signs
Duration Diarrhea Fever Abdominal pain Weight loss
Stool exam CBC Other lab findings
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Ischemic colitis + + + + + + + + + Nl
Pseudomembranous enterocolitis + + ± + + ± + + Nl
 Campylobacteriosis + + + + + + + Nl Nl Nl Nl
Salmonellosis + + + + + + + + Nl Nl
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Shigellosis + + + + + + + Nl ↑/↓
Escherichia coli enteritis EPEC + + + + + + + + + Nl Nl Nl
EIEC + + + + + + + Nl Nl Nl
EHEC + + + + + + Nl
EAEC + + + + + + + Nl
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Yersinia enterocolitica + + + + + + + Nl Nl Nl
Aeromonas + + + + + + + + Nl Nl Nl
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
Plesiomonas + + + + + + + Nl Nl Nl
Mycobacterium avium complex + + + + + + + + Nl Nl
Food poisoning + + ± + + ± + ± Nl Nl Nl
  • History of travel or ingestion of infected food
Cause Duration Diarrhea Fever Abdominal pain Weight loss GI signs Stool exam CBC Other lab findings Extra intestinal findings Cause/Pathogenesis Gold standard diagnosis
Acute Chronic Watery Bloody Fatty WBC RBC Ova/Parasite Osmotic gap Other WBC Hgb Plt
CMV colitis + + + ± + + + Nl
  • Viral antigen assay
Nl Nl
Entamoeba histolytica + + + + + + + + + Nl Nl Nl
  • Antigen testing
  • Serology 
Radiation enteritis + + + + + + + + + Nl Nl Nl

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