Infectious colitis differential diagnosis: Difference between revisions
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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, volvolus and early onset inflammatory bowel disease. In adolescents and adults, infectious colitis must be differentiated from inflammatory bowel disease and colorectal malignancy.[1][2]
Differentiating Infectious colitis from other Diseases
The differential diagnosis of Infectious colitis can be classified into two according to age group.
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 table below lists the underlying bacterial pathogens known to cause acute diarrhea:[3][4]
| Pathogen | Transmission | Clinical Manifestations | |||
|---|---|---|---|---|---|
| Fever | Nausea/Vomiting | Abdominal Pain | Bloody Stool | ||
| Salmonella | Foodborne transmission, community-acquired | ++ | + | ++ | + |
| Shigella | Community-acquired, person-to-person | ++ | ++ | ++ | + |
| Campylobacter | Community-acquired, ingestion of undercooked poultry | ++ | + | ++ | + |
| Escherichia coli | Foodborne transmission, ingestion of undercooked hamburger meat | - | + | ++ | + (EHEC or EIEC), - (ETEC, EAEC, EPEC) |
| Clostridium difficile | Nosocomial spread, antibiotic use | + | ± | + | + |
| Yersinia | Community-acquired, foodborne transmission | ++ | + | ++ | + |
| Entamoeba histolytica | Travel to or emigration from tropical regions | + | ± | + | ± |
| Aeromonas | Ingestion of contaminated water | ++ | + | ++ | + |
| Plesiomonas | Ingestion of contaminated water or undercooked shellfish, travel to tropical regions | ± | ++ | + | + |
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.