Escherichia coli enteritis differential diagnosis
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Differentiating Escherichia coli enteritis from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Serge Korjian M.D., Yazan Daaboul, M.D.
Overview
E. coli enteritis must be differentiated from other causes of abdominal pain and diarrhea, such as other infectious causes, including bacterial, viral, fungal, and parasitic causes, in addition to non-infectious causes, including acute pancreatitis, appendicitis, bowel obstruction, diverticulitis, drug reaction, hyperthyroidism, inflammatory bowel disease, mesenteric ischemia, peritonitis, and pneumonia.
Differentiating Escherichia coli Enteritis from other Diseases
- Enteritis caused by E. coli must be differentiated from other causes of acute diarrhea (with or without blood) and abdominal pain.
- Differential diagnosis of E. coli enteritis includes the following:
Infectious Differential Diagnoses
The following are the infectious differential diagnoses of E. coli enteritis. Common infectious differential diagnoses and differentiating features are shown in the table below.
- Other bacterial infections
- Viral infections (e.g. norovirus infection, HIV infection)
- Fungal infections (e.g. Candida spp.)
- Parasites (Giardia spp., E. histolytica, Cryptosporidium spp.)
Non-infectious Differential DIagnoses
The following are the non-infectious differential diagnoses of E. coli enteritis:
- Acute pancreatitis
- Adrenal insufficiency and Waterhouse-Friedrichsen syndrome
- Allergy (e.g. insect bite allergy or anaphylaxis)
- Appendicitis
- Bowel obstruction
- Diverticulitis
- Drug reaction (e.g. antimicrobial agents, antihypertensive therapy, chemotherapy, anticonvulsants)
- Endometriosis
- Familial Mediterranean fever
- Gastrointestinal perforation
- Hyperthyroidism
- Ileus
- Inflammatory bowel disease (Crohn's disease or ulcerative colitis)
- Intussusception
- Ischemic colitis
- Ketoacidosis
- Mesenteric ischemia
- Necrotizing enterocolitis
- Ogilvie syndrome
- Peritonitis
- Pneumonia
- Poisoning and toxicity (e.g. carbon monoxide poisoning, organophosphate poisoning, digitoxin toxicity)
- Ruptured abdominal aortic aneurysm
- Spider bite
- Volvulus
- Urinary tract infection
To view a comprehensive list of abdominal pain differential diagnoses, click here.
To view a comprehensive list of diarrhea differential diagnoses, click here.
The table below lists the underlying bacterial pathogens known to cause acute diarrhea:[1][2]
| 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
- ↑ 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.