Echinococcosis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];
Overview
Cystic echinococcosis must be differentiated from other diseases presenting with right sided abdominal pain such as pyogenic liver abscess and amoebic liver abscess and fungal liver abscess.
Differential Diagnosis
Echinococcal cyst must be differentiated from other diseases presenting with similar features of right sided abdominal pain such as:
Disease | Causes | Symptoms | Lab Findings | Imaging Findings | Other Findings | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Fever | Pain | Cough | Hepatomegaly | Jaundice | Weight loss | Diarrhea
or Dysentry |
Nausea and
vomiting | ||||||
Abdominal pain
(right upper quadrant pain) |
Pleuritic pain | ||||||||||||
Echinococcal (hydatid) cyst | Echinococcus granulosus | ✔ | ✔ | ✔ | ✔ | Histology: Hydatid cyst with three layers:
|
Ultrasound:
|
| |||||
Amoebic liver abscess | Entamoeba histolytica | ✔✔✔ | ✔✔✔ | ✔/✘ | ✔ | ✔✔/✘ | ✔
(late stages) |
✔
(late stages) |
✔ | ✔ | Hypoalbuminemia
Multiple neutrophilic abscess with areas of necrosis A rim of connective tissue, with few inflammatory cells and amoebic trophozoites are clustered in the fibrin at the junction of viable and necrotic tissue (✔) |
|
|
Pyogenic liver abscess | Bacteria
|
✔ | ✔ | ✔✔ | ✔✔ | ✔/✘ | ✔✔✔ | ✔
(acute loss) |
Pale/dark stool | ✔ | Hypoalbuminemia
(✔✔✔) |
Cluster sign |
|
Fungal liver abscess | Candida species Aspergillus species |
✔ | ✔ | ✔/✘ | ✔ | ✔ | ✔ | ✔ | ✔ | ✔ | CT and Us findings with four patterns of presentation:
|
| |
Malignancy
(hepatocellular carcinoma/metastasis) |
✔ | ✔
(uncommon) |
✔ | ✔ | ✔✔ | Pale/Chalky stool | ✔✔ |
|
Other symptoms: |