Cholera differential diagnosis: Difference between revisions

Jump to navigation Jump to search
Line 17: Line 17:
* Vomiting is usually absent in [[shigella]] but is frequently seen in cholera.
* Vomiting is usually absent in [[shigella]] but is frequently seen in cholera.


====Amoebic Hemorrhagic E. coli Dysentery====
====Amoebic Hemorrhagic [[E. coli]] [[Dysentery]]====
* Bloody diarrhea, which is not seen in cholera, guides clinicians toward a diagnosis of [[dysentery]].
* Bloody diarrhea, which is not seen in cholera, guides clinicians toward a diagnosis of [[dysentery]].
* The volume of stool is not as high as seen in cases of [[cholera]].
* The volume of stool is not as high as seen in cases of [[cholera]].

Revision as of 16:36, 5 April 2017

Cholera Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cholera from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Other diagnostic studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Case Studies

Case #1

Cholera differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Cholera 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 Cholera differential diagnosis

CDC on Cholera differential diagnosis

Cholera differential diagnosis in the news

Blogs on Cholera differential diagnosis

Directions to Hospitals Treating Cholera

Risk calculators and risk factors for Cholera differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]

Overview

Patients with cholera may have a history of consumption of contaminated food or water and/or travel to an endemic area. Symptoms of cholera usually develop within 24-48 hour of infection. Patient presents with sudden-onset, painless, odorless, rice-watery, large-volume stool; abdominal cramps; vomiting; and fever. Cholera should be differentiated from other infectious causes of diarrhea such as rotavirus, E. coli, amoebic dysentry, and giardiasis. Cholera should also be differentiated from some non-infectious causes of diarrhea such as VIPoma, tubulovillous adenoma, and food poisoning.[1][2][3][4]

Differentiating Cholera from other Diseases

Cholera must be differentiated from other conditions associated with acute onset diarrhea, including:[1][2][3][4]

Infectious causes of diarrhea

  • It may be difficult to differentiate cholera from other infectious causes of diarrhea, especially if it is mild and in early stages.
  • Fresh stool microscopy, stool culture, PCR, and other techniques help to differentiate these conditions. Stool tests are useful, cheap, and frequently used to differentiate cholera from other infectious conditions. Other tests (e.g., PCR, serotyping), though sensitive and specific, may not be performed due to prohibitive cost or lack of availability at many healthcare centers.

Shigella

Amoebic Hemorrhagic E. coli Dysentery

  • Bloody diarrhea, which is not seen in cholera, guides clinicians toward a diagnosis of dysentery.
  • The volume of stool is not as high as seen in cases of cholera.

Giardiasis

  • The volume of stool is not as high as in cases of cholera.
  • Stool microscopy is used to detect eggs and parasites.
  • The stool of giardiasis patients produces a strong odor, whereas cholera patients usually have odorless stools.

Strongyloides

  • The volume of stool is not as high as in cases of cholera
  • Stool microscopy is used to detect eggs and parasites

Food poisoning

  • The volume of stool is not as high as in cases of cholera

Non-infectious causes of diarrhea

VIPoma

  • Patients present with a chronic history of diarrhea
  • Volume of stool is not as high as in cases of cholera
  • Negative stool examination and culture
  • Fasting gut hormones confirm the diagnosis

Tubulovillous adenoma

  • Colonoscopy and biopsy confirm the diagnosis
  • Patients present with a chronic history of diarrhea
  • Volume of stool is not as high as in cases of cholera
  • Negative stool examination and culture

Differential Diagnosis by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic VIPoma, Tubulovillous adenoma, Food poisoning
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease Giardiasis, Amoebic dysentry, E. coli, Strongyloides,
Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

References

  1. 1.0 1.1 Sack DA, Sack RB, Nair GB, Siddique AK (2004). "Cholera". Lancet. 363 (9404): 223–33. PMID 14738797.
  2. 2.0 2.1 Krejs GJ (1987). "VIPoma syndrome". Am J Med. 82 (5B): 37–48. PMID 3035922.
  3. 3.0 3.1 Guerrant RL, Van Gilder T, Steiner TS, et al.; Infectious Diseases Society of America. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis. 2001;32(3):331–351.
  4. 4.0 4.1 Scallan, Elaine, et al. "Foodborne illness acquired in the United States—unspecified agents." Emerg Infect Dis 17.1 (2011): 16-22.

Template:WikiDoc Sources