Microsporidiosis differential diagnosis

Microsporidiosis Microchapters
Home
Patient Information
Overview
Historical perspective
Classification
Pathophysiology
Causes
Differentiating Microsporidiosis from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory findings
X ray
CT
MRI
Other imaging studies
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Microsporidiosis differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Microsporidiosis differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Microsporidiosis differential diagnosis
CDC on Microsporidiosis differential diagnosis
Microsporidiosis differential diagnosis in the news
Blogs on Microsporidiosis differential diagnosis
Directions to Hospitals Treating Microsporidiosis
Risk calculators and risk factors for Microsporidiosis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Ogheneochuko Ajari, MB.BS, MS [2];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [3]

Overview

Microsporidiosis should be differentiated from other conditions that cause chronic diarrhea in immunocompromised patients.

Differentiating Microsporidiosis from other Diseases

Differential Diagnosis

Microsporidiosis must be differentiated from other diseases that may cause chronic diarrhea, weight loss, and abdominal pain especially in immunocompromised patients.

Disease	Prominent clinical findings	Laboratory or radiological findings
Chronic giardiasis	Chronic giardiasis may develop after a bout of acute giardiasis or without any acute events. Loose foul smelling stools Flatulence Fatigue Weight loss Steatorrhea Some patients develop acquired lactose intolerance (manifested by exacerbation of symptoms following ingestion of dairy products)	Microscopic identification of the organism in the stool Hypoalbuminaemia Vitamin B12 and folate deficiencies (as the organism inhabits the duodenum)
Cryptosporidiosis	Incubation period is 7-10 days. In immunocompetent patients: Disease might be asymptomatic or cause gastroenteritis (but without any biliary involvement) Gastroenteritis usually resolves spontaneously within 14 days. In immunocompromised patients: Disease is usually more severe and prolonged (especially in severly immunocomprmised patients with CD4 count < 100 cells/microL). Cryptosporidiosis may involve the biliary tract and the liver. Weight loss Abdominal RUQ tenderness might be present if biliary or hepatic involvement is present.	Microscopic identification of the organism in the stool: The oocysts appear red on staining with modified acid fast staining PCR: is the most specific and sensitive diagnostic tool. PCR is expensive and used in limited cases.
Cystoisosporiasis (isosporiasis)	Cystoisosporiasis is usually seen in immunocompromised patients. Incubation period can last up to 2 weeks Watery diarrhea that is profuse and foul smelling Constitutional symptoms (headache, low grade fever, myalgia and malaise)	Isospora ova or parasites can be visualized on stool microscopic examination. Upper GI endoscopy may used for excluding other esophageal or gastric disease and obtaining specimens for histopathology.
Tropical sprue	History of travel to a tropical region (for a period more than a month) Chronic diarrhea Steatorrhea Examination may show signs of vitamin deficiencies (eg glossitis)	Megaloblastic anemia that might progress into pancytopenia Hypoalbuminaemia Vitamin D defeciency and hypocalcemia