Filariasis differential diagnosis: Difference between revisions
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|Cellulitis | |(Cellulitis-erysipelas-skin asbcess) | ||
|Acute painful swelling and may be fever | |Acute painful swelling and may be fever | ||
|Acute | |Acute | ||
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* Tenderness,hotness and may be flactuation if abscess formed | |||
* Lymphangitis in nearby lymph nodes. | |||
* Toxemia and fever in severe cases. | |||
* Cellulitis involves the deeper dermis erysipelas involves the upper dermis.<ref name="pmid24947530">{{cite journal| author=Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL et al.| title=Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. | journal=Clin Infect Dis | year= 2014 | volume= 59 | issue= 2 | pages= 147-59 | pmid=24947530 | doi=10.1093/cid/ciu296 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24947530 }}</ref> | |||
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* Usually it doesn't need any laboratory tests to diagnose.<ref name="pmid27434444">{{cite journal| author=Raff AB, Kroshinsky D| title=Cellulitis: A Review. | journal=JAMA | year= 2016 | volume= 316 | issue= 3 | pages= 325-37 | pmid=27434444 | doi=10.1001/jama.2016.8825 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27434444 }}</ref> | |||
* Blood cultures are warranted for patients in the following circumstances:<ref name="pmid10834819">{{cite journal| author=Woo PC, Lum PN, Wong SS, Cheng VC, Yuen KY| title=Cellulitis complicating lymphoedema. | journal=Eur J Clin Microbiol Infect Dis | year= 2000 | volume= 19 | issue= 4 | pages= 294-7 | pmid=10834819 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10834819 }}</ref> | |||
# Systemic toxicity | |||
# Extensive skin or soft tissue involvement | |||
# Underlying comorbidities | |||
# persistent cellulitis | |||
* ''In patients with recurrent cellulitis, serologic testing for beta-hemolytic streptococci is a good diagnostic tool.''<ref name="pmid4005155">{{cite journal| author=Leppard BJ, Seal DV, Colman G, Hallas G| title=The value of bacteriology and serology in the diagnosis of cellulitis and erysipelas. | journal=Br J Dermatol | year= 1985 | volume= 112 | issue= 5 | pages= 559-67 | pmid=4005155 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4005155 }}</ref> | |||
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|Other causes of generalized edema | |Other causes of generalized edema | ||
Revision as of 14:27, 30 June 2017
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Filariasis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Filariasis differential diagnosis On the Web |
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American Roentgen Ray Society Images of Filariasis differential diagnosis |
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Risk calculators and risk factors for Filariasis differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
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Filariasis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Filariasis differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Filariasis differential diagnosis |
|
Risk calculators and risk factors for Filariasis differential diagnosis |
Overview
Lymphatic filariasis must be differentiated from other causes of lower limb edema, such as chronic venous insufficiency, acute deep venous thrombosis, lipedema, myxedema, cellulitis and causes of generalized edema. Hydrocele sholud be differentiated from other causes of testicular masses. Breast lymphedema must be differentiated from breast cancer.
Differentiating filariasis from other diseases
| Diseases | Symptoms | Signs | Gold standard Investigation to diagnose | ||||||
|---|---|---|---|---|---|---|---|---|---|
| History | Onset | Pain | Fever | Laterality | Scrotal swelling | Symptoms of primary disease | |||
| Lymphatic filariasis |
|
Chronic | + | + | Bilateral | + | - |
|
Preparing Blood Smears Thick Smears Thick smears consist of a thick layer of dehemoglobinized (lysed) red blood cells (RBCs).Thick smears allow a more efficient detection of parasites (increased sensitivity). Thin Smears Thin smears consist of blood spread in a layer such that the thickness decrease. By the ultrasound, the following findings can be observed:
|
| Chronic venous insufficiency |
|
Chronic | + | - | Bilateral | +
(If congenial , Venous insufficiency un testicular veins may form scrotal swelling) |
- |
|
Duplex ultrasound will demonstrate typical findings of venous valvular insufficiency |
| Acute deep venous thrombosis |
|
Acute | + | - | Unilateral | - | May be associated with primary disease mandates recumbency for long duration | Positive Homan's sign |
|
| Lipedema | Family history especially in women; X-linked dominant or autosomal dominant condition[1] Abnormal deposition of fat and edema | Chronic | + | - | Bilateral | - | - | Tender with palpation | |
| Myxedema |
|
Chronic | + | - | Bilateral | - | +
(hypothyroidism ) |
||
| (Cellulitis-erysipelas-skin asbcess) | Acute painful swelling and may be fever | Acute | + | + | Unilateral | - | - |
|
|
| Other causes of generalized edema | History of chronic general condition(cardiac-liver-renal) | Chronic | - | - | Bilateral | - | + | According to the primary cause ( Echo- LFT- RFT) | |
References
- ↑ Child AH, Gordon KD, Sharpe P, Brice G, Ostergaard P, Jeffery S; et al. (2010). "Lipedema: an inherited condition". Am J Med Genet A. 152A (4): 970–6. doi:10.1002/ajmg.a.33313. PMID 20358611.
- ↑ Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL; et al. (2014). "Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America". Clin Infect Dis. 59 (2): 147–59. doi:10.1093/cid/ciu296. PMID 24947530.
- ↑ Raff AB, Kroshinsky D (2016). "Cellulitis: A Review". JAMA. 316 (3): 325–37. doi:10.1001/jama.2016.8825. PMID 27434444.
- ↑ Woo PC, Lum PN, Wong SS, Cheng VC, Yuen KY (2000). "Cellulitis complicating lymphoedema". Eur J Clin Microbiol Infect Dis. 19 (4): 294–7. PMID 10834819.
- ↑ Leppard BJ, Seal DV, Colman G, Hallas G (1985). "The value of bacteriology and serology in the diagnosis of cellulitis and erysipelas". Br J Dermatol. 112 (5): 559–67. PMID 4005155.