Gastroenteritis differential diagnosis: Difference between revisions

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Revision as of 16:29, 5 September 2012

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Differentiating Gastroenteritis from other Diseases

It is important to consider infectious gastroenteritis as a diagnosis per exclusionem.

A few loose stools and vomiting may be the result of systemic infection such as

Surgical conditions such as
- Appendicitis
- Intussusception
- Hirschsprung's disease may mislead the clinician.

Non-infectious causes to consider are
- Poisoning with heavy metals i.e. (Arsenic,cadmium)
- Seafood (i.e. ciguatera, scombroid, toxic encephalopathic shellfish poisoning) or mushrooms (i.e. Amanita phalloides).
- Secretory tumours (i.e. carcinoid, medullary tumour of the thyroid, vasoactive intestinal peptide-secreting adenomas) and **Endocrine disorders (i.e. thyrotoxicosis and Addison's disease) are disorders that can cause diarrhea.
- Also, pancreatic insufficiency, short bowel syndrome, Whipple's disease, coeliac disease, and laxative abuse should be excluded as possibilities.

References

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@@ Line 4: / Line 4: @@
 ==Overview==
-== Differential diagnosis ==
+==Differentiating Gastroenteritis from other Diseases ==
-[[image:Gastroenteritis_viruses.jpg|left|thumb|350px|Gastroenteritis viruses: A= rotavirus, B = Adenovirus, C = Norovirus and D = Astrovirus. The virus particles are shown at the same magnification to allow size comparision.]]
-It is important to consider infectious gastroenteritis as a [[Diagnosis of exclusion|diagnosis per exclusionem]].  A few loose stools and vomiting may be the result of systemic [[infection]] such as [[pneumonia]], [[septicemia]], [[urinary tract infection]] and even [[meningitis]].  Surgical conditions such as [[appendicitis]], [[intussusception]] and, rarely, even [[Hirschsprung's disease]] may mislead the clinician.
+It is important to consider infectious gastroenteritis as a [[Diagnosis of exclusion|diagnosis per exclusionem]].
-Non-infectious causes to consider are poisoning with heavy metals (i.e. [[arsenic]], [[cadmium]]), seafood (i.e. [[ciguatera]], [[scombroid]], toxic encephalopathic shellfish poisoning) or mushrooms (i.e. [[Amanita phalloides]]). Secretory tumours (i.e. [[carcinoid]], medullary tumour of the thyroid, [[Vipoma|vasoactive intestinal peptide-secreting adenomas]]) and endocrine disorders (i.e. [[thyrotoxicosis]] and [[Addison's disease]]) are disorders that can cause diarrhea.  Also, pancreatic insufficiency, [[short bowel syndrome]], [[Whipple's disease]], [[coeliac disease]], and laxative abuse should be excluded as possibilities. Infectious gastroenteritis is caused by a wide variety of [[bacteria]] and [[virus]]es.  For a list of bacteria causing gastroenteritis, see above.  Viruses causing gastroenteritis include [[rotavirus]], [[norovirus]], [[adenovirus]] and [[astrovirus]].
+* A few loose stools and vomiting may be the result of systemic [[infection]] such as
+** [[Pneumonia]]
+** [[Septicemia]]
+** [[Urinary tract infection]]
+** [[Meningitis]].
+* Surgical conditions such as
+** [[Appendicitis]]
+** [[Intussusception]]
+** [[Hirschsprung's disease]] may mislead the clinician.
+* Non-infectious causes to consider are
+** Poisoning with heavy metals i.e. ([[Arsenic]],[[cadmium]])
+** Seafood (i.e. [[ciguatera]], [[scombroid]], toxic encephalopathic shellfish poisoning) or mushrooms (i.e. [[Amanita phalloides]]).
+** Secretory tumours (i.e. [[carcinoid]], medullary tumour of the thyroid, [[Vipoma|vasoactive intestinal peptide-secreting adenomas]]) and **Endocrine disorders (i.e. [[thyrotoxicosis]] and [[Addison's disease]]) are disorders that can cause diarrhea.
+** Also, pancreatic insufficiency, [[short bowel syndrome]], [[Whipple's disease]], [[coeliac disease]], and laxative abuse should be excluded as possibilities.
-If gastroenteritis in a child is severe enough to require admission to a hospital, then it is important to distinguish between bacterial and viral infections. Bacteria, [[shigella]] and [[campylobacter]], for example, and [[parasite]]s like [[giardia]] can be treated with [[antibiotic]]s, but viruses do not respond to antibiotics and infected children usually make a full recovery after a few days.<ref name="pmid1649479">{{cite journal |author=Haffejee IE |title=The pathophysiology, clinical features and management of rotavirus diarrhoea |journal=Q. J. Med. |volume=79 |issue=288 |pages=289–99 |year=1991 |pmid=1649479 |doi=}}</ref> Children admitted to hospital with gastroenteritis routinely are tested for rotavirus A to gather surveillance data relevant to the epidemiological effects of rotavirus vaccination programs.<ref name="pmid17901797">{{cite journal |author=Patel MM, Tate JE, Selvarangan R, ''et al'' |title=Routine laboratory testing data for surveillance of rotavirus hospitalizations to evaluate the impact of vaccination |journal=Pediatr. Infect. Dis. J. |volume=26 |issue=10 |pages=914–9 |year=2007 |pmid=17901797 |doi=10.1097/INF.0b013e31812e52fd}}</ref><ref name="pmid16650331">{{cite journal |author= |title=The paediatric burden of rotavirus disease in Europe |journal=Epidemiol. Infect. |volume=134 |issue=5 |pages=908–16 |year=2006 |pmid=16650331 |doi=10.1017/S0950268806006091}}</ref> These children are routinely tested also for [[norovirus]], which is extraordinarily infectious and requires special isolation procedures to avoid transmission to other patients.  Other methods, [[electron microscopy]] and [[Gel electrophoresis|polyacrylamide gel electrophoresis]], are used in research laboratories.<ref name="pmid3132369">{{cite journal |author=Beards GM |title=Laboratory diagnosis of viral gastroenteritis |journal=Eur. J. Clin. Microbiol. Infect. Dis. |volume=7 |issue=1 |pages=11–3 |year=1988 |pmid=3132369 |doi=}}</ref><ref name="pmid1321223">{{cite journal |author=Steel HM, Garnham S, Beards GM, Brown DW |title=Investigation of an outbreak of rotavirus infection in geriatric patients by serotyping and polyacrylamide gel electrophoresis (PAGE) |journal=J. Med. Virol. |volume=37 |issue=2 |pages=132–6 |year=1992 |pmid=1321223 |doi=}}</ref>
 ==References==
 {{Reflist|2}}
-[[Category:Pediatrics]]
-[[Category:Gastroenterology]]
-[[Category:Foodborne illnesses]]
-[[Category:Infectious disease]]
-[[Category:Inflammations]]
-[[Category:Abdominal pain]]
-[[Category:Conditions diagnosed by stool test]]
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Gastroenteritis differential diagnosis: Difference between revisions

Revision as of 16:29, 5 September 2012

Overview

Differentiating Gastroenteritis from other Diseases

References

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