Filariasis differential diagnosis: Difference between revisions
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==Differentiating filariasis from other diseases== | ==Differentiating filariasis from other diseases== | ||
Lymphatic filariasis must be differentiated from other causes of lower limb edema: | |||
{| class="wikitable" | {| class="wikitable" | ||
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| Chronic venous insufficiency | | [[Chronic venous insufficiency]] | ||
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* Skin change distribution correlate with varicose veins sites in the medial side of ankle and leg | * Skin change distribution correlate with varicose veins sites in the medial side of ankle and leg | ||
* Reduction of swelling with limb elevation. | * Reduction of swelling with limb elevation. | ||
|Duplex ultrasound will demonstrate typical findings of venous valvular insufficiency | |[[Duplex ultrasound]] will demonstrate typical findings of venous valvular insufficiency | ||
|- | |- | ||
|Acute deep venous thrombosis | |[[Deep venous thrombosis|Acute deep venous thrombosis]] | ||
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* History of prolonged recumbency | * History of prolonged recumbency | ||
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* Compression ultrasonography (CUS) with Doppler is the diagnostic test of choice | * [[Compression ultrasonography]] (CUS) with Doppler is the diagnostic test of choice | ||
* D-dimer is used for unprobable cases | * [[D-dimer]] level is used for unprobable cases | ||
|- | |- | ||
|Lipedema | |[[Lipedema]] | ||
|Family history especially in women; X-linked dominant or autosomal dominant condition<ref name="pmid20358611">{{cite journal| author=Child AH, Gordon KD, Sharpe P, Brice G, Ostergaard P, Jeffery S et al.| title=Lipedema: an inherited condition. | journal=Am J Med Genet A | year= 2010 | volume= 152A | issue= 4 | pages= 970-6 | pmid=20358611 | doi=10.1002/ajmg.a.33313 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20358611 }}</ref> Abnormal deposition of fat and edema and '''easy bruising'''. | |Family history especially in women; X-linked dominant or autosomal dominant condition<ref name="pmid20358611">{{cite journal| author=Child AH, Gordon KD, Sharpe P, Brice G, Ostergaard P, Jeffery S et al.| title=Lipedema: an inherited condition. | journal=Am J Med Genet A | year= 2010 | volume= 152A | issue= 4 | pages= 970-6 | pmid=20358611 | doi=10.1002/ajmg.a.33313 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20358611 }}</ref> Abnormal deposition of fat and edema and '''easy bruising'''. | ||
|Chronic | |Chronic | ||
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|MRI offers strong qualitative and quantitative parameters in the diagnosis of lipedema <ref name="pmid9412843">{{cite journal| author=Dimakakos PB, Stefanopoulos T, Antoniades P, Antoniou A, Gouliamos A, Rizos D| title=MRI and ultrasonographic findings in the investigation of lymphedema and lipedema. | journal=Int Surg | year= 1997 | volume= 82 | issue= 4 | pages= 411-6 | pmid=9412843 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9412843 }}</ref> | |MRI offers strong qualitative and quantitative parameters in the diagnosis of lipedema <ref name="pmid9412843">{{cite journal| author=Dimakakos PB, Stefanopoulos T, Antoniades P, Antoniou A, Gouliamos A, Rizos D| title=MRI and ultrasonographic findings in the investigation of lymphedema and lipedema. | journal=Int Surg | year= 1997 | volume= 82 | issue= 4 | pages= 411-6 | pmid=9412843 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9412843 }}</ref> | ||
|- | |- | ||
|Myxedema | |[[Myxedema]] | ||
| | | | ||
* History of untreated hypothyroidism | * History of untreated hypothyroidism | ||
* Infiltration of the skin with glycosaminoglycans with associated water retention | * Infiltration of the skin with [[Glycosaminoglycan|glycosaminoglycans]] with associated water retention | ||
|Chronic | |Chronic | ||
| + | | + | ||
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| - | | - | ||
| + | | + | ||
(hypothyroidism ) | ([[hypothyroidism]] ) | ||
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|(Cellulitis-erysipelas-skin | |([[Cellulitis]]-[[Erysipelas|erysipelas-]]<nowiki/>skin abcess) | ||
|Acute painful swelling and may be fever | |Acute painful swelling and may be fever | ||
|Acute | |Acute | ||
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# Underlying comorbidities | # Underlying comorbidities | ||
# persistent cellulitis | # 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> | * ''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> | ||
|- | |- | ||
|Other causes of generalized edema | |Other causes of generalized edema | ||
Revision as of 15:16, 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]
|
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
Lymphatic filariasis must be differentiated from other causes of lower limb edema:
| 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 |
|
|
| Lipedema | Family history especially in women; X-linked dominant or autosomal dominant condition[2] Abnormal deposition of fat and edema and easy bruising. | Chronic | + | - | Bilateral | - | - | Tender with palpation
Negative Semmer sign to differentiate from liphedema;[3] (pinching) the skin on the upper surface of the toes. If it t is possible to grasp a thin fold of tissue the it is negative result. In a positive result, it is only possible to grasp a lump of tissue. |
MRI offers strong qualitative and quantitative parameters in the diagnosis of lipedema [4] |
| Myxedema |
|
Chronic | + | - | Bilateral | - | + | ||
| (Cellulitis-erysipelas-skin abcess) | 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
- ↑ Goodacre S, Sutton AJ, Sampson FC (2005). "Meta-analysis: The value of clinical assessment in the diagnosis of deep venous thrombosis". Ann Intern Med. 143 (2): 129–39. PMID 16027455. Review in: ACP J Club. 2006 Mar-Apr;144(2):46-7 Review in: Evid Based Med. 2006 Apr;11(2):56
- ↑ 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.
- ↑ Trayes KP, Studdiford JS, Pickle S, Tully AS (2013). "Edema: diagnosis and management". Am Fam Physician. 88 (2): 102–10. PMID 23939641.
- ↑ Dimakakos PB, Stefanopoulos T, Antoniades P, Antoniou A, Gouliamos A, Rizos D (1997). "MRI and ultrasonographic findings in the investigation of lymphedema and lipedema". Int Surg. 82 (4): 411–6. PMID 9412843.
- ↑ 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.