Infectious colitis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [2]
Overview
Symptoms and signs of infectious colitis are seen in other causes of colitis and some systemic diseases. Infectious colitis must be differentiated from other diseases that cause fever, bloody diarrhea, dehydration, tachycardia and low blood pressure. Therefore, detailed history, physical examination and laboratory tests are needed to make the diagnosis. In addition, endoscopy with biopsy may be required to confirm the diagnosis. In infants and young children, infectious colitis must be differentiated from allergic colitis, necrotizing enterocolitis, intussusception, volvulus and early onset inflammatory bowel disease. In adolescents and adults, infectious colitis must be differentiated from inflammatory bowel disease and colorectal malignancy.
Differentiating Infectious colitis from other Diseases
The differential diagnosis of Infectious colitis can be classified into two according to age group.[1][2]
Differential diagnosis in Infants/ young children
- Allergic colitis
- Necrotizing enterocolitis especially in preterm babies
- Intussusception
- Hirschsprung disease complicated by enterocolitis
- Volvolus
- Inflammatory bowel disease early onset)
Differential diagnosis in adolescent/ adult
- Inflammatory bowel disease
- Diverticulosis
- Allergic colitis
- Henoch-Schonlein purpura
- Systemic lupus erythematosus(SLE)
- Colorectal malignancy
- Behcet's disease
- The symptoms of colitis such as diarrhea especially bloody diarrhea and abdominal pain are seen are seen in all forms of colitis. The table below lists the differential diagnosis of common causes of colitis:[3][4]
| Diseases | History and Symptoms | Physical Examination | Laboratory findings | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Diarrhea | Rectal bleeding | Abdominal pain | Atopy | Dehydration | Fever | Hypotension | Malnutrition | Blood in stool (frank or occult) | Microorganism in stool | Pseudomembranes on endoscopy | Lab Test 4 | |
| Allergic Colitis | + | ++ | + | ++ | ++ | |||||||
| Chemical colitis | + | ++ | ++ | + | + | ++ | + | |||||
| Infectious colitis | ++ | ++ | ++ | +++ | +++ | ++ | + | ++ | ++ | + | ||
| Radiation colitis | + | ++ | + | + | + | ++ | ||||||
| Ischemic colitis | + | + | ++ | + | + | + | + | ++ | ||||
| Drug-induced colitis | + | + | ++ | + | ++ | + | ||||||
References
- ↑ Palle SK, Prasad M, Kugathasan S (2016). "Approach to a Child with Colitis". Indian J Pediatr. doi:10.1007/s12098-016-2091-5. PMID 27080713.
- ↑ DuPont HL (2012). "Approach to the patient with infectious colitis". Curr Opin Gastroenterol. 28 (1): 39–46. doi:10.1097/MOG.0b013e32834d3208. PMID 22080825.
- ↑ Thielman NM, Guerrant RL (2004). "Clinical practice. Acute infectious diarrhea". N Engl J Med. 350 (1): 38–47. doi:10.1056/NEJMcp031534. PMID 14702426.
- ↑ Khan AM, Faruque AS, Hossain MS, Sattar S, Fuchs GJ, Salam MA (2004). "Plesiomonas shigelloides-associated diarrhoea in Bangladeshi children: a hospital-based surveillance study". J Trop Pediatr. 50 (6): 354–6. doi:10.1093/tropej/50.6.354. PMID 15537721.