Differentiating (disease name) from other diseases page

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

Introduction to the Differentiating (Disease Name) From Other Diseases Page

• This chapter covers the process that is traditionally known as "differential diagnosis".
• The page name should be "Differentiating (disease name) from other diseases", with only the first letter of the title capitalized.
• Goal: To provide information on a systematic method of differentiating a given disease from other diseases that may present similarly.
• For an example of a microchapter on differentiating disease, click here.
• Search the disease database (http://diseasesdatabase.com/content.asp) to assure the content for this page is complete.
• As with all microchapter pages linking to the main page, at the top of the edit box put {{CMG}}, your name template, and the microchapter navigation template you created at the beginning.
• Remember to create links within Wikidoc by placing [[square brackets]] around key words which you want to link to other pages. Make sure you make your links as specific as possible. For example if a sentence contained the phrase anterior spinal artery syndrome, the link should be to anterior spinal artery syndrome not anterior or artery or syndrome. For more information on how to create links click here.
• Remember to follow the same format and capitalization of letters as outlined in the template below.
• You should include the name of the disease in the first sentence of every subsection.

Overview

• The overview section should include the disease name in the first sentence.
• The goal is to summarize the page several sentences, usually stating the categories that the disease is classified by.
• This section can be the same as the differentiating disease section in the overview page.

Template

• First Sentence:

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from other causes of [symptom/sign], such as [Differential 1], [Differential 2], and [Differential 3].

• Examples:

Example 1: Hepatitis C must be differentiated from other diseases that cause hepatic injury and abnormal liver function tests, such as other viral hepatitides (Hepatitis A, Hepatitis B, and Hepatitis E), alcoholic liver disease, non-alcoholic steatohepatitis, drug-induced liver injury, autoimmune hepatitis, and hepatocellular carcinoma.

Example 2: Colorectal cancer must be differentiated from other diseases that cause unexplained weight loss, unexplained loss of appetite, abdominal discomfort, nausea, vomiting, diarrhea, anemia, and fatigue, such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), hemorrhoids, anal fissures, and diverticular disease.

Example 3: Colorectal cancer must be differentiated from Irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), hemorrhoids, anal fissures, and diverticular disease.

Example 4: Pericarditis must be differentiated from other causes of chest pain, such as myocardial infarction, aortic dissection, and pulmonary embolism.

Differentiating (Disease name) from other Diseases

• In this section you will outline the conditions or diseases that may often be confused with the disease you are describing.
• You can list the diseases, include major clinical features of each differential diagnosis including major symptoms, physical exam findings, and provide a brief description of how each disease is different from the one you are describing, as seen here.
• You can differentiate physical examination characteristics from those of similar diseases.
• You can also provide guidance on the distinguishing characteristics of the physical exam findings, the laboratory findings, and other diagnostic modalities.
• A table may be helpful. It should be preceded by the following sentence:

The table below summarizes the findings that differentiate ______ dz from other conditions that cause ____symptom and _____ signs:

• The use of the following symbols may be helpful within a table:
  • check marks ✔ and cross marks ✘, to signify the presence or absence of qualitative findings.
  • ↑ and ↓ ,to signify elevations and reductions in quantitative findings.
  • + , ++, or +++ to signify varying levels of quantitative findings.
• The following table may be used as a general template for differentiating diseases from one another:

Diseases	Laboratory Findings				Physical Examination				History and Symptoms				Other Findings
	Lab Test 1	Lab Test 2	Lab Test 3	Lab Test 4	Physical Finding 1	Physical Finding 2	Physical Finding 3	Physical Finding 4	Finding 1	Finding 2	Finding 3	Finding 4
Differential Diagnosis 1			+						✔
Differential Diagnosis 2	↑									✘
Differential Diagnosis 3		↓
Differential Diagnosis 4
Differential Diagnosis 5

Examples:

The following tables may be used as examples of different table styles for differentiating disease:

Example 1

The table below summarizes the different findings between Pericarditis and Myocardial infarction:

Characteristic/Parameter	Pericarditis	Myocardial infarction
Pain description	Sharp, pleuritic, retro-sternal (under the sternum) or left precordial (left chest) pain.	Crushing, pressure-like, heavy pain. Described as "elephant on the chest".
Radiation	Pain radiates to the trapezius ridge (to the lowest portion of the scapula on the back) or no radiation.	Pain radiates to the jaw, or the left or arm, or does not radiate.
Exertion	Does not change the pain	Can increase the pain
Position	Pain is worse supine or upon inspiration (breathing in)	Not positional
Onset/duration	Sudden pain, that lasts for hours or sometimes days before a patient comes to the ER	Sudden or chronically worsening pain that can come and go in paroxysms or it can last for hours before the patient decides to come to the ER

Example 2

The table below summarizes the findings that differentiate Shigellosis from other conditions that cause fever and hemorrhage:

Disease	Findings
EHEC	May present with fever, chills vomiting, diarrhea, generalized pain or malaise, and gastointestinal bleeding that follow an incubation period of 3-7 days. Unlike E. coli, Shigella cannot ferment lactose or decarboxylate lysine.
Ebola	Presents with fever, chills vomiting, diarrhea, generalized pain or malaise, and sometimes internal and external bleeding, that follow an incubation period of 2-21 days.
Typhoid fever	Presents with fever, headache, rash, gastrointestinal symptoms, with lymphadenopathy, relative bradycardia, cough and leucopenia and sometimes sore throat. Blood and stool culture can confirm the presence of the causative bacteria.
Malaria	Presents with acute fever, headache and sometimes diarrhea (children). A blood smears must be examined for malaria parasites. The presence of parasites does not exclude a concurrent viral infection. An antimalarial should be prescribed as an empiric therapy.
Lassa fever	Disease onset is usually gradual, with fever, sore throat, cough, pharyngitis, and facial edema in the later stages. Inflammation and exudation of the pharynx and conjunctiva are common.
Yellow fever and other Flaviviridae	Present with hemorrhagic complications. Epidemiological investigation may reveal a pattern of disease transmission by an insect vector. Virus isolation and serological investigation serves to distinguish these viruses. Confirmed history of previous yellow fever vaccination will rule out yellow fever.
Others	Viral hepatitis, leptospirosis, rheumatic fever, typhus, and mononucleosis can produce signs and symptoms that may be confused with Ebola in the early stages of infection.

Example 3

The table below summarizes the findings that differentiate Sexually transmitted diseases:

Disease	Symptoms								Other symptoms
	Discharge	Dysuria	Vaginal odor	Dyspareunia	Genital skin lesion	Genital pruritis	Fever	Lymphadenopathy
Chlamydia	✔	✔		✔		✔	✔	✔	Cough, shortness of breath, red eye with discharge (neonate), joint pains
Gonorrhea	✔	✔	✔	✔			✔		Sore throat, polyarthralgia, tenosynovitis, rash, eye discharge (neonates)
HIV	✔	✔					✔	✔	Fever, lymphadenopathy, rash, fatigue, myalgia, arthritic pain, headache
Herpes simplex	✔	✔			✔		✔	✔	Fatigue, myalgias, painful oral ulcers
HPV	✔	✔		✔	✔	✔			Weight loss, hoarseness (adults), altered cry, stridor(infants)
Hepatitis B							✔	✔	Fever, fatigue, nausea, vomiting, loss of appetite, abdominal pain, dark urine, clay-colored bowel movements,joint pain, yellowish discoloration of the eyes and skin, skin rash, muscle pain
Hepatitis C							✔	✔	Fever, fatigue, anorexia, arthralgia, nausea, vomiting
Bacterial vaginosis	✔		✔						None
Mycoplasma genitalium	✔	✔		✔		✔			None
Zika virus							✔		Conjunctivitis, rash, joint pains

References

• References should be cited for the material that you have put on your page. Type in {{reflist|2}}.This will generate your references in small font, in two columns, with links to the original article and abstract.
• For information on how to add references into your page, click here

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