HIV AIDS differential diagnosis: Difference between revisions

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{{AIDS}}
{{AIDS}}
{{CMG}}; {{AE}} [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]], {{Ammu}}
{{CMG}}; {{AE}} [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]], {{Ammu}}
==Overview==
==Overview==
AIDS is an immunodeficiency disease. It should be considered in patient presenting with symptoms of [[immunodeficiency]]. AIDS should be distinguished from [[congenital]] disorders and considered in the differential diagnosis of childhood immunodeficiency.
Acute HIV infection may be asymptomatic or may cause a [[mononucleosis]]-like syndrome. It should be differentiated from similar diseases that cause [[fever]], [[fatigue]], [[sore throat]], [[myalgia]], and [[lymphadenopathy]] such as acute [[toxoplasmosis]], acute [[CMV]]/[[EBV]] infections, and [[acute viral hepatitis]]. On the other hand, AIDS should be considered in all patients presenting with symptoms of [[immunodeficiency]] or [[opportunistic infections]]. It should be distinguished from various medical states that cause immunosuppression including [[common variable immune deficiency]] (CVID), [[chemotherapy]] treatment, [[steroid]] therapy, and severe [[malnutrition]].<ref name="Health">{{cite web | title = AIDSinfo| url = http://aidsinfo.nih.gov/ }}</ref>


The possibility of HIV infection should be considered on a case-by-case basis and other causes of immune suppression must be considered.  
==Differential Diagnosis==
===Acute HIV===
{| style="border: 0px; font-size: 90%; margin: 0px; width: 900px"
! style="background: #4479BA" |{{fontcolor|#FFF| '''''Disorder'''''}}
! style="background: #4479BA" |{{fontcolor|#FFF| '''''Disease Definition'''''}}
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |[[Burkitt's lymphoma]]
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |Burkitt's lymphoma (or "Burkitt's tumor", or "[[Malignant lymphoma]], Burkitt's type") is a cancer of the lymphatic system (in particular, B lymphocytes). It is associated with the [[Epstein-Barr virus]], also the cause of infectious mononucleosis as well as other cancers such as nasopharyngeal carcinoma and thymic carcinoma.


Various medical conditions that cause immunosuppression are [[chemotherapy]], [[immune]] disorders, [[severe combined immune deficiency]] [SCID], severe [[malnutrition]].
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |[[Influenza]]


==Differentiating AIDS from other Diseases==
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Influenza]] is an infectious disease caused by  RNA viruses of the biological family [[Orthomyxoviridae]]. The common symptoms of influenza infection are [[fever]], [[sore throat]], muscle [[pain]]s, severe [[headache]], [[coughing]], weakness and general discomfort. In more serious cases, [[influenza]] causes [[pneumonia]], which can be fatal, particularly in young children and the elderly


{|style="border: 0px; font-size: 90%; margin: 0px;"
! style="background: #4479BA"|{{fontcolor|#FFF| '''''Disorder'''''}}
! style="background: #4479BA"|{{fontcolor|#FFF| '''''Disease Definition'''''}}
|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Burkitt lymphoma]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |Streptococcal [[pharyngitis]]
| style="background: #F5F5F5; padding: 0 5px;" valign=top |Burkitt's lymphoma (or "Burkitt's tumor", or "[[Malignant lymphoma]], Burkitt's type") is a cancer of the lymphatic system (in particular, B lymphocytes). It is associated with the [[Epstein-Barr virus]], also the cause of mononucleosis as well as other cancers
 
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |Streptococcal [[pharyngitis]] is a form of group A streptococcal [[infection]] that affects the [[pharynx]], and possibly the [[larynx]] and [[tonsils]] and presents as sore throat. Similar symptoms may be seen with acute HIV syndrome


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Influenza]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |[[Viral gastroenteritis]]


| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Influenza]], commonly known as flu, is an infectious disease of birds and mammals caused by  RNA viruses of the biological family [[Orthomyxoviridae]] (the [[influenza]] viruses). In humans, common symptoms of influenza infection are [[fever]], [[sore throat]], muscle [[pain]]s, severe [[headache]], [[coughing]], weakness and general discomfort. In more serious cases, [[influenza]] causes [[pneumonia]], which can be fatal, particularly in young children and the elderly
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Gastroenteritis]] is the inflammation of the stomach and the small and large intestines. Viral [[gastroenteritis]] is an [[infection]] caused by a variety of viruses or bacteria that presents with abdominal pain, [[vomiting]], and/or [[diarrhea]].


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |Streptococcal [[pharyngitis]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |Viral upper respiratory tract infection


| style="background: #F5F5F5; padding: 0 5px;" valign=top |Streptococcal [[pharyngitis]] or streptococcal sore throat (Strep throat AmE), is a form of group A streptococcal [[infection]] that affects the [[pharynx]], and possibly the [[larynx]] and [[tonsils]] and presents as [[sorethroat]].
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |A variety of acute viral infections of the upper respiratory tract can cause symptoms similar to the acute HIV syndrome including fever, [[myalgia]], [[pharyngitis]], and [[malaise]].


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Viral gastroenteritis]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |Acute viral [[hepatitis]]


| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Gastroenteritis]] is the inflammation of the stomach and the small and large [[intestines.]] Viral [[gastroenteritis]] is an [[infection]] caused by a variety of viruses that results in [[vomiting]] or [[diarrhea]]. It is often called the "stomach flu," although it is not caused by the [[influenza]] [[viruses]].
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |Acute viral inflammation of the [[liver]] can cause loss of [[appetite]], [[malaise]], [[jaundice]] and other constitutional syndromes similar to acute HIV.


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Viral upper respiratory tract infection]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |Primary [[herpes]] simplex infection


| style="background: #F5F5F5; padding: 0 5px;" valign=top |Acute viral infection of the upper respiratory tract can cause symptoms similar to [[AIDS]] like [[sore throat]], [[pharyngitis]], [[malaise]] and [[pharyngitis]].
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Herpes simplex]] is a viral infection that causes that can produce various symptoms depending on the sites of [[infection]]. Oral [[herpes]] can cause cold sores in mouth and is the most common for of [[Infection]]. It can have active and latent phases. Although [[Herpes]] can occur as an opportunistic [[infection]] in the immunocompromised state of [[AIDS]] infection, primary [[herpes simplex]] infection can be a differential diagnosis of [[AIDS]].


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |Acute viral [[hepatitis]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |Secondary [[syphilis]]
 
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |After 4-10 weeks of primary [[syphilis]] , [[secondary syphilis]] can occur affecting [[skin]], [[mucous membrane]] and [[lymph nodes]]. They can present with [[fever]], [[malaise]], [[sore throat]], [[weight loss]], [[headache]] , [[hair loss]].


| style="background: #F5F5F5; padding: 0 5px;" valign=top |Acute viral inflammation of [[liver]] can cause loss of [[appetite]], [[malaise]], [[jaundice]] and other constitutional syndromes
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |Acute [[CMV]] infection


| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |Human [[cytomegalovirus]] is a  genus of [[viruses]] belonging to the viral family herpesviridae. CMV [[infection]] is typically unnoticed in healthy people, but can be life-threatening for immunocompromised patients, particularly those with AIDS, [[organ transplant]] recipients, and newborns. CMV infections may present with a mononucleosis-like syndrome seen in patients with acute HIV syndrome.
|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |Primary [[herpes]] simplex infection
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |Acute [[toxoplasmosis]]


| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Herpes simplex]] is a viral infection that causes that can produce various symptoms depending on the sites of [[infection]]. Oral [[herpes]] can cause cold sores in mouth and is the most common for of [[Infection]]. It can have active and latent phases. Although [[Herpes]] can occur as an opportunistic [[infection]] in the immunocompromised state of [[AIDS]] infection, primary [[herpes simplex]] infection can be a differential diagnosis of [[AIDS]].
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |A [[parasitic disease]] caused by ingestion of cat feces, affect all organs and particularly dangerous in [[pregnant]] woman. Toxoplasma infections may also present with a mononucleosis-like syndrome seen in patients with acute HIV syndrome.


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |Secondary [[syphilis]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |[[Brucellosis]]


| style="background: #F5F5F5; padding: 0 5px;" valign=top |After 4-10 weeks of primary [[syphilis]] , [[secondary syphilis]] can occur affecting [[skin]], [[mucous membrane]] and [[lymph nodes]]. They can present with [[fever]], [[malaise]], [[sore throat]], [[weight loss]], [[headache]] , [[hair loss]].
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Brucellosis]] is a Zoonotic disease caused by bacteria of the genus [[Brucella]]. It is primarily a disease of domestic animals (goats, pigs, cattle, dogs, etc) and humans and has a worldwide distribution, mostly now in developing countries.


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |Acute [[cytomegalo infection]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |Disseminated [[goncoccemia]]
 
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Gonococcemia]]  is a condition characterized by a hemorrhagic vesiculopustular eruption, bouts of [[fever]], and [[arthralgia]] or [[arthritis]].


| style="background: #F5F5F5; padding: 0 5px;" valign=top |Human [[cytomegalovirus]] is a  genus of [[viruses]], which in turn is a member of the viral family known as [[herpesviruses]]. Although they may be found throughout the body, [[HCMV]] infections are frequently associated with the [[salivary glands]]. HCMV [[infection]] is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised, such as [[HIV-infected persons]], [[organ transplant]] recipients, or [[new born]].
|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |Acute [[toxoplasmosis]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |[[Measles]]


| style="background: #F5F5F5; padding: 0 5px;" valign=top |A [[parasitic disease]] caused by ingestion of cat feces, affect all organs and particulary dangerous to [[preganant]] woman.
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Measles]] is a disease caused by the measles virus belonging to the genus [[Morbillivirus]]. It is transmitted into by contact and aerosols. Symptoms include the appearance of a diffuse maculopapular rash along with fever, cough, coryza, conjunctivitis, malaise, and fatigue.


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Brucellosis]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |[[Meningitis]]/[[Encephalitis]]


| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Brucellosis]] is a Zoonotic disease caused by bacteria of the genus [[Brucella]]. It is primarily a disease of domestic animals (goats, pigs, cattle, dogs, etc) and humans and has a worldwide distribution, mostly now in developing countries
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Encephalitis]] is an acute inflammation of the brain, commonly caused by a viral or bacterial [[infection]]s.


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Disseminated goncoccemia]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |Primary immunodeficiencies


| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Gonococcemia]]  is a condition characterized by a hemorrhagic vesiculopustular eruption, bouts of [[fever]], and [[arthralgia]] or [[actual arthritis]] of one or several joints
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |Other immunodeficiency syndromes can produce similar symptoms of [[AIDS]]. These include primary congenital immunodeficiencies, secondary immunodeficiencies particularly iatrogenic and neoplastic in nature.


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Measles]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |[[Malaria]]


| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Measles]] is a disease caused by the [[Morbillivirus]]. It is transmitted into the respiratory by contact with infected fluids. [[Incubation]] lasts for 4-12 days, during which patients are asymptomatic. Symptomatic onset includes the appearance of a distinct rash. Infected people remain contagious from 5 days before appearance to until 4 days after.  
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Malaria]] is a vector-borne infectious disease caused by protozoan parasites. [[Malaria]] is one of the most common infectious diseases and an enormous public-health problem. The disease is caused by protozoan parasites of the genus [[Plasmodium]]. The most serious forms of the disease are caused by [[Plasmodium falciparum]] and [[Plasmodium vivax]], but other related species ([[Plasmodium ovale]],[[ Plasmodium malariae]], and sometimes [[Plasmodium]] knowlesi) can also infect humans. Malaria may present with cyclical fevers, myalgia, and other flu-like syndromes that may be observed in patients with acute HIV syndrome.


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Meningitis]]/[[Encephalitis]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |[[Typhoid]]


| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Encephalitis]] is an acute inflammation of the brain, commonly caused by a viral [[infection]]. Sometimes, [[encephalitis]] can result from a bacterial [[infection]], such as bacterial [[meningitis]], or it may be a complication of other infectious diseases like [[rabies]] (viral) or [[syphilis]] (bacterial). Certain parasitic or [[protozoal infestations]], such as [[toxoplasmosis]], [[malaria]], or primary [[amoebic meningoencephalitis]], can also cause encephalitis in people with compromised immune systems. Brain damage occurs as the inflamed brain pushes against the skull, and can lead to death.  
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Typhoid]] [[fever]], also known as enteric [[fever]], is an illness caused by the bacterium [[Salmonella enterica serovar typhi]]. Common worldwide, it is transmitted by the  fecal-oral route. Symptoms include adbominal pain, fever, malaise, headache, and bradycardia.


|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |Primary immunodeficiencies
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign="top" |[[Rubella]]


| style="background: #F5F5F5; padding: 0 5px;" valign=top |Other immunodeficient diseases can produce similar symptoms of [[AIDS]].
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" |[[Rubella]] is a common childhood infection usually with minimal systemic manifestations. Transplacental infection is a particular concern given the increased risk of congenital defects.
|}


===AIDS===
The table shown bellow describes the most common conditions that should be differentiated from AIDS as they all cause immunodeficiency and patients with those diseases are prone to opportunistic infections.
{| style="border: 0px; font-size: 90%; margin: 0px; width:900px"
! style="background: #4479BA; width: 150px" |{{fontcolor|#FFF| '''''Condition'''''}}
! style="background: #4479BA; width: 450px" |{{fontcolor|#FFF| '''''Description'''''}}
|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Malaria]]
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" |Cancer <ref>{{cite web|url=http://www.cancer.gov/cancertopics/aya/types| title=National Cancer Institute - Cancers In Young People}}</ref>
 
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" | Most hematological cancers and some solid cancers are associated with acquired immunodeficiency and should be ruled out. These include [[leukemia]]s, [[lymphoma]]s, [[plasmacytoma]]s, [[melanoma]], and [[central nervous system tumors]].
| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Malaria]] is a vector-borne infectious disease caused by [[protozoan parasites]]. [[Malaria]] is one of the most common infectious diseases and an enormous public-health problem. The disease is caused by protozoan parasites of the genus [[Plasmodium]]. The most serious forms of the disease are caused by [[Plasmodium falciparum]] and [[Plasmodium vivax]], but other related species ([[Plasmodium ovale]],[[ Plasmodium malariae]], and sometimes [[Plasmodium]] knowlesi) can also infect humans. This group of human-pathogenic [[Plasmodium ]]species is usually referred to as [[malaria]] parasites
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" |Chemotherapy <ref name="pmid25352632">{{cite journal| author=Morrison VA| title=Immunosuppression associated with novel chemotherapy agents and monoclonal antibodies. | journal=Clin Infect Dis | year= 2014 | volume= 59 Suppl 5 | issue=  | pages= S360-4 | pmid=25352632 | doi=10.1093/cid/ciu592 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25352632  }} </ref><ref name="pmid25065776">{{cite journal| author=Fabiani S, Bruschi F| title=Rheumatological patients undergoing immunosuppressive treatments and parasitic diseases: a review of the literature of clinical cases and perspectives to screen and follow-up active and latent chronic infections. | journal=Clin Exp Rheumatol | year= 2014 | volume= 32 | issue= 4 | pages= 587-96 | pmid=25065776 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25065776  }} </ref>
| style="background: #F5F5F5; padding: 5px 5px;" | Immunosuppresive drugs will used in the treatment of cancer, rheumatic diseases, and following organ transplants diminish the immune response by interfering with nucleic acid synthesis and decreasing the subsets of B and T cells.  Examples include [[methotrexate]], [[azathioprine]], [[mercaptopurine]], [[fluorouracil]], and [[dactinomycin]].
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" |Steroid Therapy
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" | [[Glucocorticoids]] act by inhibiting genes that code for the [[cytokines]] and humoral activity, which leads to immunosuppresion when used for long periods of time. Opportunistic infections such as [[candidiasis]] or [[herpes zoster]] may be seen in these patients.
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" |Malnutrition
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" | Patients with malnutrition will have a weakened immune system due to the lack of essential nutrients to create new immune cells and are prone to infections that are also seen in AIDS. Special populations are prone to malnutrition, such as kids ([[marasmus]], [[kwashiorkor]]) and the elderly.
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" |[[Common Variable Immunodeficiency]] ([[CVID]])
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" | Patients with CVID are usually between 20 and 40 years old and their cellular and humoral immune system are affected. CVID should be ruled out if the HIV test is negative and the patient presents with immunodeficiency.  
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" |Other Congenital Immunodeficiencies
| style="background: #F5F5F5; padding: 5px 5px;" valign="top" | These include: [[Severe Combined Immunodeficiency]] (SCID), [[X-linked agammaglobulinemia]], [[DiGeorge syndrome]], and [[Wiskott-Aldrich syndrome]].
|}


AIDS must be differentiated from other causes of rash and arthritis<ref name="pmid3101626">{{cite journal| author=Rompalo AM, Hook EW, Roberts PL, Ramsey PG, Handsfield HH, Holmes KK| title=The acute arthritis-dermatitis syndrome. The changing importance of Neisseria gonorrhoeae and Neisseria meningitidis. | journal=Arch Intern Med | year= 1987 | volume= 147 | issue= 2 | pages= 281-3 | pmid=3101626 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3101626  }} </ref><ref name="pmid16297736">{{cite journal| author=Rice PA| title=Gonococcal arthritis (disseminated gonococcal infection). | journal=Infect Dis Clin North Am | year= 2005 | volume= 19 | issue= 4 | pages= 853-61 | pmid=16297736 | doi=10.1016/j.idc.2005.07.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16297736  }} </ref><ref name="pmid22353959">{{cite journal| author=Bleich AT, Sheffield JS, Wendel GD, Sigman A, Cunningham FG| title=Disseminated gonococcal infection in women. | journal=Obstet Gynecol | year= 2012 | volume= 119 | issue= 3 | pages= 597-602 | pmid=22353959 | doi=10.1097/AOG.0b013e318244eda9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22353959  }} </ref>


{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Disease}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|Findings}}
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''Nongonococcal [[septic arthritis]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Presents with an acute onset of joint swelling and pain (usually monoarticular)
*Culture of joint fluid reveals organisms
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Acute rheumatic fever]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Presents with polyarthritis and rash (rare presentation) in young adults. Microbiologic or serologic evidence of a recent streptococcal infection confirm the diagnosis.
*Poststreptococcal arthritis have a rapid response to [[salicylate]]s or other [[antiinflammatory drugs]].
|-
| style="padding: 5px 5px; background: #DCDCDC;" |'''[[Syphilis]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Presents with acute secondary syphilis usually presents with generalized, pustular lesions at the palms and soles with [[lymphadenopathy|generalized lymphadenopathy]]
*Rapid plasma reagin (RPR), Venereal Disease Research Laboratory (VDRL) and Fluorescent treponemal antibody absorption (FTA-ABS) tests confirm the presence of the causative agent.
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Reactive arthritis]] (Reiter syndrome)'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Musculoskeletal manifestation include [[arthritis]], [[tenosynovitis]], [[dactylitis]], and low back pain.
*Extraarticular manifestation include [[conjunctivitis]], [[urethritis]], and genital and oral lesions.
*Reactive arthritis is a clinical diagnosis based upon the pattern of findings and there is no definitive diagnostic test
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Hepatitis B virus|Hepatitis B virus (HBV) infection]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Presents with fever, chills, polyarthritis, [[tenosynovitis]], and [[urticarial|urticarial rash]]
*Synovial fluid analysis usually shows noninflammatory fluid
*Elevated [[aminotransaminases|serum aminotransaminases]] and evidence of acute HBV infection on serologic testing confirm the presence of the HBV.
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Herpes simplex virus|Herpes simplex virus (HSV)]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Genital and extragenital lesions can mimic the skin lesions that occur in disseminated gonococcal infection
*Viral culture,  [[polymerase chain reaction|polymerase chain reaction (PCR)]], and direct fluorescence antibody confirm the presence of the causative agent.
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[HIV infection]] '''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Present with generalized rash with mucus membrane involvement, fever, chills, and [[arthralgia]]. Joint effusions are uncommon
|-
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Gout|Gout and other crystal-induced arthritis]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Presents with acute monoarthritis with fever and chills
*Synovial fluid analysis confirm the diagnosis.
|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Typhoid]]
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Lyme disease]]'''
| style="padding: 5px 5px; background: #F5F5F5;" |  
*Present with erythema chronicum migrans rash and [[monoarthritis]] as a later presentation.
*Clinical characteristics of the rash and and serologic testing confirm the diagnosis.
|}


| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Typhoid]] [[fever]], also known as enteric [[fever]] and [[Salmonella typhi infection]], is an illness caused by the bacterium [[Salmonella enterica serovar typhi]]. Common worldwide, it is transmitted by the  fecal-oral route — the ingestion of food or water contaminated with feces from an infected person. The [[bacteria]] then multiply in the blood stream of the infected person and are absorbed into the digestive tract and eliminated with the waste.
==Other Differentials==
AIDS should be differentiated from other conditions presenting with [[fever]], [[fatigue]], [[weight loss]], [[arthralgia]], [[myalgia]], [[rash]] and [[soft tissue]] [[swelling]]. The differentials include the following:<ref name="pmid18163139">{{cite journal |vauthors=Ejilemele AA, Nwauche CA, Ejele OA |title=Pattern of abnormal liver enzymes in HIV patients presenting at a Nigerian Tertiary Hospital |journal=Niger Postgrad Med J |volume=14 |issue=4 |pages=306–9 |date=December 2007 |pmid=18163139 |doi= |url=}}</ref><ref name="pmid1579936">{{cite journal |vauthors=Gøransson LG, Omdal R, Husby G |title=[Adult-onset Still's disease. Diagnosis, differential diagnosis and treatment] |language=Norwegian |journal=Tidsskr. Nor. Laegeforen. |volume=112 |issue=9 |pages=1155–5 |date=March 1992 |pmid=1579936 |doi= |url=}}</ref><ref name="pmid21734024">{{cite journal |vauthors=Hatakka A, Klein J, He R, Piper J, Tam E, Walkty A |title=Acute hepatitis as a manifestation of parvovirus B19 infection |journal=J. Clin. Microbiol. |volume=49 |issue=9 |pages=3422–4 |date=September 2011 |pmid=21734024 |pmc=3165617 |doi=10.1128/JCM.00575-11 |url=}}</ref><ref name="pmid25780346">{{cite journal |vauthors=Yaguchi D, Marui N, Matsuo M |title=Three Adult Cases of HPV-B19 Infection with Concomitant Leukopenia and Low Platelet Counts |journal=Clin Med Insights Case Rep |volume=8 |issue= |pages=19–22 |date=2015 |pmid=25780346 |pmc=4345940 |doi=10.4137/CCRep.S18085 |url=}}</ref><ref name="pmid11810534">{{cite journal |vauthors=Díaz F, Collazos J |title=Hepatic dysfunction due to parvovirus B19 infection |journal=J. Infect. Chemother. |volume=6 |issue=1 |pages=63–4 |date=March 2000 |pmid=11810534 |doi=10.1007/s101560000023 |url=}}</ref><ref name="urlwatermark.silverchair.com">{{cite web |url=https://watermark.silverchair.com/22-5-783.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAaUwggGhBgkqhkiG9w0BBwagggGSMIIBjgIBADCCAYcGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMNepsAzlRiawaxgMCAgEQgIIBWCcwAN4r_jjoL6cD8qOBCgCIgpagHIemSBzmiP_c08L34mY51H7ulShPj9n2yDVBVRols0OgZEIsKVl8kHD_89enHvhFrJOIh8cF7GxZ_AXULME_iReJXr37VWLU5bWFrtZHafAg_cvOdP8mr5u5K8TzGLBtd5VfQb2MGyXZhz-hpKGZbfMr33rJio00VHcFn_aS5wjB-h6fny_rsD4fwLj5xSWNB0_JEYq9g0-mS7y_igwhIZlismSrS4-svrkx46SDLpKqkTrJmImyDBGTj1Qi3INV8KT66j4j6z2wju7sRKvWxQAsoJhN6D8zxx5PQkth3gLDch3wLW_sn9o8q7sBlO25ONobKarrln8nwsS4f-9wHmPs82ZySggX4SgVtrMn6tr3lMVcroGV9fjOIcQQuk_KRq01ErxBdPtynPVbAZhmInGIJ0_LYqvOKplDpNnMHZZaEQYd |title=watermark.silverchair.com |format= |work= |accessdate=}}</ref><ref name="pmid23355575">{{cite journal |vauthors=Shetty RK, Vivek G, Naha K, Bekkam S |title=Right-sided infective endocarditis presenting with purpuric skin rash and cardiac failure in a patient without fever |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=January 2013 |pmid=23355575 |pmc=3603787 |doi=10.1136/bcr-2012-007841 |url=}}</ref><ref name="pmid23133445">{{cite journal |vauthors=Aucott JN, Crowder LA, Yedlin V, Kortte KB |title=Bull's-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans |journal=Dermatol Res Pract |volume=2012 |issue= |pages=451727 |date=2012 |pmid=23133445 |pmc=3485866 |doi=10.1155/2012/451727 |url=}}</ref><ref name="pmid21772606">{{cite journal |vauthors=Karaali Z, Baysal B, Poturoglu S, Kendir M |title=Cutaneous manifestations in brucellosis |journal=Indian J Dermatol |volume=56 |issue=3 |pages=339–40 |date=May 2011 |pmid=21772606 |pmc=3132922 |doi=10.4103/0019-5154.82505 |url=}}</ref><ref name="pmid18843212">{{cite journal |vauthors=La Spada E, Micalizzi A, La Spada M, Quartarano P, Nugara G, Soresi M, Affronti M, Montalto G |title=[Abnormal liver function in brucellosis] |language=Italian |journal=Infez Med |volume=16 |issue=3 |pages=148–53 |date=September 2008 |pmid=18843212 |doi= |url=}}</ref><ref name="pmid17235095">{{cite journal |vauthors=French P |title=Syphilis |journal=BMJ |volume=334 |issue=7585 |pages=143–7 |date=January 2007 |pmid=17235095 |pmc=1779891 |doi=10.1136/bmj.39085.518148.BE |url=}}</ref><ref name="urlSyphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features">{{cite web |url=http://cmr.asm.org/content/12/2/187.full |title=Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features |format= |work= |accessdate=}}</ref><ref name="pmid24700957">{{cite journal |vauthors=Baveja S, Garg S, Rajdeo A |title=Syphilitic hepatitis: an uncommon manifestation of a common disease |journal=Indian J Dermatol |volume=59 |issue=2 |pages=209 |date=March 2014 |pmid=24700957 |pmc=3969699 |doi=10.4103/0019-5154.127711 |url=}}</ref><ref name="pmid1600010">{{cite journal |vauthors=Mawhorter SD, Effron D, Blinkhorn R, Spagnuolo PJ |title=Cutaneous manifestations of toxoplasmosis |journal=Clin. Infect. Dis. |volume=14 |issue=5 |pages=1084–8 |date=May 1992 |pmid=1600010 |doi= |url=}}</ref><ref name="pmid24662942">{{cite journal |vauthors=Flegr J, Prandota J, Sovičková M, Israili ZH |title=Toxoplasmosis--a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries |journal=PLoS ONE |volume=9 |issue=3 |pages=e90203 |date=2014 |pmid=24662942 |pmc=3963851 |doi=10.1371/journal.pone.0090203 |url=}}</ref><ref name="pmid21887062">{{cite journal |vauthors=Furtado JM, Smith JR, Belfort R, Gattey D, Winthrop KL |title=Toxoplasmosis: a global threat |journal=J Glob Infect Dis |volume=3 |issue=3 |pages=281–4 |date=July 2011 |pmid=21887062 |pmc=3162817 |doi=10.4103/0974-777X.83536 |url=}}</ref><ref name="pmid10808314">{{cite journal |vauthors=Ripert C |title=[Reactive hypereosinophilia in parasitic diseases] |language=French |journal=Rev Prat |volume=50 |issue=6 |pages=602–7 |date=March 2000 |pmid=10808314 |doi= |url=}}</ref><ref name="pmid21569516">{{cite journal |vauthors=Alvarado-Esquivel C, Torres-Berumen JL, Estrada-Martínez S, Liesenfeld O, Mercado-Suarez MF |title=Toxoplasma gondii infection and liver disease: a case-control study in a northern Mexican population |journal=Parasit Vectors |volume=4 |issue= |pages=75 |date=May 2011 |pmid=21569516 |pmc=3105944 |doi=10.1186/1756-3305-4-75 |url=}}</ref><ref name="pmid5339237">{{cite journal |vauthors=Han T, Stutzman L |title=Mode of spread in patients with localized malignant lymphoma |journal=Arch. Intern. Med. |volume=120 |issue=1 |pages=1–7 |date=July 1967 |pmid=5339237 |doi= |url=}}</ref><ref name="pmid23071471">{{cite journal |vauthors=Saeed-Abdul-Rahman I, Al-Amri AM |title=Castleman disease |journal=Korean J Hematol |volume=47 |issue=3 |pages=163–77 |date=September 2012 |pmid=23071471 |pmc=3464333 |doi=10.5045/kjh.2012.47.3.163 |url=}}</ref><ref name="pmid230714712">{{cite journal |vauthors=Saeed-Abdul-Rahman I, Al-Amri AM |title=Castleman disease |journal=Korean J Hematol |volume=47 |issue=3 |pages=163–77 |date=September 2012 |pmid=23071471 |pmc=3464333 |doi=10.5045/kjh.2012.47.3.163 |url=}}</ref><ref name="pmid21063526">{{cite journal |vauthors=Papadavid E, Panayiotides I, Dalamaga M, Katoulis A, Economopoulos T, Stavrianeas N |title=Cutaneous involvement in angioimmunoblastic T-cell lymphoma |journal=Indian J Dermatol |volume=55 |issue=3 |pages=279–80 |date=2010 |pmid=21063526 |pmc=2965920 |doi=10.4103/0019-5154.70704 |url=}}</ref><ref name="pmid26120552">{{cite journal |vauthors=Brockow K, Przybilla B, Aberer W, Bircher AJ, Brehler R, Dickel H, Fuchs T, Jakob T, Lange L, Pfützner W, Mockenhaupt M, Ott H, Pfaar O, Ring J, Sachs B, Sitter H, Trautmann A, Treudler R, Wedi B, Worm M, Wurpts G, Zuberbier T, Merk HF |title=Guideline for the diagnosis of drug hypersensitivity reactions: S2K-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Dermatological Society (DDG) in collaboration with the Association of German Allergologists (AeDA), the German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Contact Dermatitis Research Group (DKG), the Swiss Society for Allergy and Immunology (SGAI), the Austrian Society for Allergology and Immunology (ÖGAI), the German Academy of Allergology and Environmental Medicine (DAAU), the German Center for Documentation of Severe Skin Reactions and the German Federal Institute for Drugs and Medical Products (BfArM) |journal=Allergo J Int |volume=24 |issue=3 |pages=94–105 |date=2015 |pmid=26120552 |pmc=4479479 |doi=10.1007/s40629-015-0052-6 |url=}}</ref><ref name="pmid15745878">{{cite journal |vauthors=Medlej-Hashim M, Loiselet J, Lefranc G, Mégarbané A |title=[Familial Mediterranean Fever (FMF): from diagnosis to treatment] |language=French |journal=Sante |volume=14 |issue=4 |pages=261–6 |date=2004 |pmid=15745878 |doi= |url=}}</ref><ref name="pmid27142780">{{cite journal |vauthors=Zhang S |title=Natural history of mevalonate kinase deficiency: a literature review |journal=Pediatr Rheumatol Online J |volume=14 |issue=1 |pages=30 |date=May 2016 |pmid=27142780 |pmc=4855321 |doi=10.1186/s12969-016-0091-7 |url=}}</ref>


{| class="wikitable"
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category of Disease
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Diseases
! colspan="10" align="center" style="background:#4479BA; color: #FFFFFF;" + |Signs and symptoms
! colspan="11" align="center" style="background:#4479BA; color: #FFFFFF;" + |Laboratory findings
|-
| rowspan="2" |'''Fever'''
| rowspan="2" |'''Fatigue'''
| rowspan="2" |'''Arthralgia'''
| rowspan="2" |'''Myalgia'''
| rowspan="2" |'''Soft tissue swelling/serositis'''
| rowspan="2" |'''Skin rash'''
| rowspan="2" |'''Weight loss'''
| rowspan="2" |'''Dyspnea'''
| rowspan="2" |'''Sore throat'''
| rowspan="2" |'''Lymphadenopathy'''
| rowspan="2" |'''Complete blood count (CBC)'''
| rowspan="2" |'''Liver function tests (LFTs)'''
| colspan="2" |
=== Inflammatory markers ===
| colspan="6" |
=== Autoantibodies ===
|
=== Diagnostic tests ===
|-
|'''Erythrocyte sedimentation rate (ESR)'''
|'''C- reactive protein (CRP)'''
|'''Anti-nuclear antibodies (ANA)'''
|'''Rheumatoid factor (RF)'''
|'''Anti- glomerular basement membrane (anti-GBM)'''
|'''Anti-dsDNA'''
|'''Anti-Jo1/ Anti Mi2'''
|'''ANCA'''
|
|-
| rowspan="9" |
=== Infections ===
| [[Human Immunodeficiency Virus (HIV)|'''HIV''']]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+ /-</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukopenia]]
* [[Anemia]]
* [[Thrombocytopenia]]
|
* [[Alanine transaminase|ALT]]'''↑'''
* [[Aspartate transaminase|AST]]'''↑'''
|'''↑'''
|'''↑'''
| -
| -
| -
| -
| -
| -
|
|-
| ''[[Herpesviridae|'''Herpesviridae''']]''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
* Papular or vesicular
* [[Erythematous]] base
* Painful
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukocytosis]]
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|
|-
| '''[[Measles]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|
* 3-5 days after fever
* [[Erythematous]] [[maculopapular]] rash starts on face spreads to trunk and [[extremities]] (centrifugal)
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukocytosis]]
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|
|-
| '''[[Hepatitis|Viral hepatitis]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Leukocytosis]]
|
* [[Alanine transaminase|ALT]]'''↑'''
* [[Aspartate transaminase|AST]]'''↑'''
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|
|-
| ''[[Parvovirus B19|'''Parvovirus B19''']]''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|
* Slapped cheek rash
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukopenia]]
* [[Aplastic anemia]] (low [[reticulocyte]] count)
* [[Thrombocytopenia]]
|
* [[Alanine transaminase|ALT]]'''↑'''
* [[Aspartate transaminase|AST]]'''↑'''
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|
|-
|'''[[Infective endocarditis]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|
* [[Purpuric]]
|<nowiki>+/-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukocytosis]]
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|Blood cultures, ultrasonography
|-
|'''[[Borreliosis]], [[Brucellosis]], [[Yersiniosis]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|
* Target rash ([[Borrelia]])
* Diffuse [[maculopapular]] ([[Brucellosis]])
* [[Erythema nodosum]] ([[Yersiniosis]])
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukocytosis]]
|
* [[Alanine transaminase|ALT]]'''↑'''
* [[Aspartate transaminase|AST]]'''↑'''
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|Serology, PCR
|-
|'''[[Syphilis]] and [[Jarisch-Herxheimer reaction]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|
* Non-pruritic
* [[Macular]]
* On palms and soles
* Round
* Seen in [[secondary syphilis]]
* [[Penis|Penile]] [[ulceration]] (painless)
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukocytosis]]
|
* [[Alanine transaminase|ALT]]'''↑''' (Uncommon)
* [[Aspartate transaminase|AST]]'''↑''' (Uncommon)
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|Serology, PCR
|-
|'''[[Toxoplasmosis]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|
* [[Maculopapular]]
* Palms and soles
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukocytosis]] (eosinophilia)
|
|
|
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|Serology, PCR
|-
|
| colspan="22" |
|-
| rowspan="3" |
=== Neoplasia ===
|'''[[Malignant lymphoma]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|
* Purplish scaly rash in cases of [[cutaneous]] [[lymphoma]]
|<nowiki>+</nowiki>
|<nowiki>+ </nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Anemia of chronic disease]]
|
* In case of [[liver]] [[metastasis]] ([[Non-Hodgkin lymphoma]]):
** [[Alanine transaminase|ALT]]'''↑'''
** [[Aspartate transaminase|AST]]'''↑'''
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|CT, PET/CT, Bone marrow examination, lymph node biopsy
|-
|'''[[Castleman's disease|Multicentric Castleman disease]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Anemia]]
* [[Thrombocytopenia]]
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|Lymph node biopsy
|-
|'''[[Angioimmunoblastic T-cell lymphoma|Angioimmunoblastic T cell lymphoma]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* [[Maculopapular]] eruption on the trunk mimicking [[Erythema toxicum|toxic erythema]]
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Lymphocytosis]]
|
* [[Alanine transaminase|ALT]]'''↑'''
* [[Aspartate transaminase|AST]]'''↑'''
|'''↑'''
|↑
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|Lymph node biopsy
|-
|
| colspan="22" |
|-
|
=== Drug hypersensitivity ===
|Drug reaction with eosinophilia and systemic symptoms
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Urticaria|Utricaria]] (Immediate type)
* [[Maculopapular]] (Delayed type)
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* [[Leukocytosis]] ([[eosinophilia]])
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|Eosinophil count, skin biopsy
|-
|
| colspan="22" |
|-
| rowspan="7" |
=== Autoimmune conditions ===
|'''[[Systemic lupus erythematosus]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>+</nowiki>
|
* Butter-fly shaped [[erythematous]] malar rash that spares the [[nasolabial folds]]
* Coin-shaped [[erythematous]] rash on extremities or trunk
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Leukopenia]]
* [[Hemolytic anemia]]
* [[Thrombocytopenia]]
|
* [[ALT]]'''↑'''
* [[AST]]'''↑'''
|'''↑'''
|'''↑'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
| -
| -
|Antinuclear autoantibodies
|-
|'''Inflammatory myositis'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+ (weakness > pain)</nowiki>
|<nowiki>-</nowiki>
|
* [[Macular]] red rash over the back of the fingers, elbows or knees (Grotton's sign)
* [[Macular]] purpish or reddish rash on the upper chest or back  (Shawl-like, heliotrope rash)
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Leukocytosis]]
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| +
| -
|Idem, muscle biopsy
|-
|[[Rheumatoid arthritis|'''Rheumatoid arthritis''']]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Purpura]]
* [[Ulcers]]
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Anemia of chronic disease]]
* [[Neutropenia]] ([[Felty's syndrome]])
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>+/-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
| -
| -
|Anti-citrullinated peptids autoantibodies, rheumatoid factor
|-
|'''[[Systemic vasculitides]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* Nasopharyngeal ulceration ([[Wegener's granulomatosis|Wegner's granulomatosis]])
* [[Erythematous]] rash on palms and soles ([[Kawasaki disease]])
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Leukocytosis]]
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|<nowiki>-</nowiki>
| -
| +
|ANCA, tissue biopsy, arteriography
|-
|'''[[Familial mediterranean fever|Familial Mediterranean fever]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
* Red rash on [[lower extremities]] (ankles and knees)
|<nowiki>+</nowiki>
|<nowiki>+ (due to pain)</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+/-</nowiki>
|
* [[Leukocytosis]] (during acute flares)
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|Familial history, MEFV gene analysis
|-
|'''[[Mevalonate kinase deficiency]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|
* [[Maculopapular]] rash
* [[Aphthous ulcers]] (or [[stomatitis]]) 
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukocytosis]] (during acute flares)
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|Urinary mevalonic acid, mevalonate kinase analysis
|-
|'''[[Reactive arthritis]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* [[Keratoderma blennorrhagica]] (palms, soles, scrotum)
* Circinate balanitis (penile)
|<nowiki>-</nowiki>
| + ([[Aortic insufficiency]])
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Leukocytosis]]
|<nowiki>-</nowiki>
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|HLA B27, magnetic resonance imaging
|-
|
| colspan="22" |
|-
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold;" valign=top |[[Rubella]]
|
 
=== Miscellaneous ===
| style="background: #F5F5F5; padding: 0 5px;" valign=top |[[Rubella]] is a common childhood infection usually with minimal systemic upset although transient [[arthropathy]] may occur in adults. Serious complications are very rare. If it were not for the effects of [[transplacental infection]] on the developing fetus, [[rubella]] is a relatively trivial [[infection]].
|'''[[Sarcoidosis]]'''
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* Waxy skin [[plaques]]
* Violaceous facial lesions
* [[Erythema nodosum]]
|<nowiki>+</nowiki>
|<nowiki>+</nowiki>
|<nowiki>-</nowiki>
|<nowiki>+</nowiki>
|
* [[Lymphopenia]]
* [[Eosinophilia]]
|
* Normal [[Alanine transaminase|ALT]], [[Aspartate transaminase|AST]]
* [[Alkaline phosphatase|ALP]] '''↑ (infiltrative pattern)'''
|'''↑'''
|'''↑'''
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|<nowiki>-</nowiki>
|
* Lymph node/Lung biopsy
* ACE levels
* FDG-PET
|}
|}


==References==
==References==
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{{Viral diseases}}
{{STD/STI}}
{{STD/STI}}
{{WH}}
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[[Category:HIV/AIDS]]
[[Category:HIV/AIDS]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Immune system disorders]]
[[Category:Immune system disorders]]
[[Category:Infectious disease]]
[[Category:Viral diseases]]
[[category:viral diseases]]
[[Category:Pandemics]]
[[Category:Pandemics]]
[[Category:Sexually transmitted infections]]
[[Category:Sexually transmitted infections]]
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[[Category:Immunodeficiency]]
[[Category:Immunodeficiency]]
[[Category:Microbiology]]
[[Category:Microbiology]]
 
[[Category:Emergency mdicine]]
{{WH}}
[[Category:Up-To-Date]]
{{WS}}
[[Category:Infectious disease]]

Latest revision as of 22:11, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ujjwal Rastogi, MBBS, Ammu Susheela, M.D. [2]

Overview

Acute HIV infection may be asymptomatic or may cause a mononucleosis-like syndrome. It should be differentiated from similar diseases that cause fever, fatigue, sore throat, myalgia, and lymphadenopathy such as acute toxoplasmosis, acute CMV/EBV infections, and acute viral hepatitis. On the other hand, AIDS should be considered in all patients presenting with symptoms of immunodeficiency or opportunistic infections. It should be distinguished from various medical states that cause immunosuppression including common variable immune deficiency (CVID), chemotherapy treatment, steroid therapy, and severe malnutrition.[1]

Differential Diagnosis

Acute HIV

Disorder Disease Definition
Burkitt's lymphoma Burkitt's lymphoma (or "Burkitt's tumor", or "Malignant lymphoma, Burkitt's type") is a cancer of the lymphatic system (in particular, B lymphocytes). It is associated with the Epstein-Barr virus, also the cause of infectious mononucleosis as well as other cancers such as nasopharyngeal carcinoma and thymic carcinoma.
Influenza Influenza is an infectious disease caused by RNA viruses of the biological family Orthomyxoviridae. The common symptoms of influenza infection are fever, sore throat, muscle pains, severe headache, coughing, weakness and general discomfort. In more serious cases, influenza causes pneumonia, which can be fatal, particularly in young children and the elderly
Streptococcal pharyngitis Streptococcal pharyngitis is a form of group A streptococcal infection that affects the pharynx, and possibly the larynx and tonsils and presents as sore throat. Similar symptoms may be seen with acute HIV syndrome
Viral gastroenteritis Gastroenteritis is the inflammation of the stomach and the small and large intestines. Viral gastroenteritis is an infection caused by a variety of viruses or bacteria that presents with abdominal pain, vomiting, and/or diarrhea.
Viral upper respiratory tract infection A variety of acute viral infections of the upper respiratory tract can cause symptoms similar to the acute HIV syndrome including fever, myalgia, pharyngitis, and malaise.
Acute viral hepatitis Acute viral inflammation of the liver can cause loss of appetite, malaise, jaundice and other constitutional syndromes similar to acute HIV.
Primary herpes simplex infection Herpes simplex is a viral infection that causes that can produce various symptoms depending on the sites of infection. Oral herpes can cause cold sores in mouth and is the most common for of Infection. It can have active and latent phases. Although Herpes can occur as an opportunistic infection in the immunocompromised state of AIDS infection, primary herpes simplex infection can be a differential diagnosis of AIDS.
Secondary syphilis After 4-10 weeks of primary syphilis , secondary syphilis can occur affecting skin, mucous membrane and lymph nodes. They can present with fever, malaise, sore throat, weight loss, headache , hair loss.
Acute CMV infection Human cytomegalovirus is a genus of viruses belonging to the viral family herpesviridae. CMV infection is typically unnoticed in healthy people, but can be life-threatening for immunocompromised patients, particularly those with AIDS, organ transplant recipients, and newborns. CMV infections may present with a mononucleosis-like syndrome seen in patients with acute HIV syndrome.
Acute toxoplasmosis A parasitic disease caused by ingestion of cat feces, affect all organs and particularly dangerous in pregnant woman. Toxoplasma infections may also present with a mononucleosis-like syndrome seen in patients with acute HIV syndrome.
Brucellosis Brucellosis is a Zoonotic disease caused by bacteria of the genus Brucella. It is primarily a disease of domestic animals (goats, pigs, cattle, dogs, etc) and humans and has a worldwide distribution, mostly now in developing countries.
Disseminated goncoccemia Gonococcemia is a condition characterized by a hemorrhagic vesiculopustular eruption, bouts of fever, and arthralgia or arthritis.
Measles Measles is a disease caused by the measles virus belonging to the genus Morbillivirus. It is transmitted into by contact and aerosols. Symptoms include the appearance of a diffuse maculopapular rash along with fever, cough, coryza, conjunctivitis, malaise, and fatigue.
Meningitis/Encephalitis Encephalitis is an acute inflammation of the brain, commonly caused by a viral or bacterial infections.
Primary immunodeficiencies Other immunodeficiency syndromes can produce similar symptoms of AIDS. These include primary congenital immunodeficiencies, secondary immunodeficiencies particularly iatrogenic and neoplastic in nature.
Malaria Malaria is a vector-borne infectious disease caused by protozoan parasites. Malaria is one of the most common infectious diseases and an enormous public-health problem. The disease is caused by protozoan parasites of the genus Plasmodium. The most serious forms of the disease are caused by Plasmodium falciparum and Plasmodium vivax, but other related species (Plasmodium ovale,Plasmodium malariae, and sometimes Plasmodium knowlesi) can also infect humans. Malaria may present with cyclical fevers, myalgia, and other flu-like syndromes that may be observed in patients with acute HIV syndrome.
Typhoid Typhoid fever, also known as enteric fever, is an illness caused by the bacterium Salmonella enterica serovar typhi. Common worldwide, it is transmitted by the fecal-oral route. Symptoms include adbominal pain, fever, malaise, headache, and bradycardia.
Rubella Rubella is a common childhood infection usually with minimal systemic manifestations. Transplacental infection is a particular concern given the increased risk of congenital defects.

AIDS

The table shown bellow describes the most common conditions that should be differentiated from AIDS as they all cause immunodeficiency and patients with those diseases are prone to opportunistic infections.

Condition Description
Cancer [2] Most hematological cancers and some solid cancers are associated with acquired immunodeficiency and should be ruled out. These include leukemias, lymphomas, plasmacytomas, melanoma, and central nervous system tumors.
Chemotherapy [3][4] Immunosuppresive drugs will used in the treatment of cancer, rheumatic diseases, and following organ transplants diminish the immune response by interfering with nucleic acid synthesis and decreasing the subsets of B and T cells. Examples include methotrexate, azathioprine, mercaptopurine, fluorouracil, and dactinomycin.
Steroid Therapy Glucocorticoids act by inhibiting genes that code for the cytokines and humoral activity, which leads to immunosuppresion when used for long periods of time. Opportunistic infections such as candidiasis or herpes zoster may be seen in these patients.
Malnutrition Patients with malnutrition will have a weakened immune system due to the lack of essential nutrients to create new immune cells and are prone to infections that are also seen in AIDS. Special populations are prone to malnutrition, such as kids (marasmus, kwashiorkor) and the elderly.
Common Variable Immunodeficiency (CVID) Patients with CVID are usually between 20 and 40 years old and their cellular and humoral immune system are affected. CVID should be ruled out if the HIV test is negative and the patient presents with immunodeficiency.
Other Congenital Immunodeficiencies These include: Severe Combined Immunodeficiency (SCID), X-linked agammaglobulinemia, DiGeorge syndrome, and Wiskott-Aldrich syndrome.

AIDS must be differentiated from other causes of rash and arthritis[5][6][7]

Disease Findings
Nongonococcal septic arthritis
  • Presents with an acute onset of joint swelling and pain (usually monoarticular)
  • Culture of joint fluid reveals organisms
Acute rheumatic fever
  • Presents with polyarthritis and rash (rare presentation) in young adults. Microbiologic or serologic evidence of a recent streptococcal infection confirm the diagnosis.
  • Poststreptococcal arthritis have a rapid response to salicylates or other antiinflammatory drugs.
Syphilis
  • Presents with acute secondary syphilis usually presents with generalized, pustular lesions at the palms and soles with generalized lymphadenopathy
  • Rapid plasma reagin (RPR), Venereal Disease Research Laboratory (VDRL) and Fluorescent treponemal antibody absorption (FTA-ABS) tests confirm the presence of the causative agent.
Reactive arthritis (Reiter syndrome)
  • Musculoskeletal manifestation include arthritis, tenosynovitis, dactylitis, and low back pain.
  • Extraarticular manifestation include conjunctivitis, urethritis, and genital and oral lesions.
  • Reactive arthritis is a clinical diagnosis based upon the pattern of findings and there is no definitive diagnostic test
Hepatitis B virus (HBV) infection
  • Presents with fever, chills, polyarthritis, tenosynovitis, and urticarial rash
  • Synovial fluid analysis usually shows noninflammatory fluid
  • Elevated serum aminotransaminases and evidence of acute HBV infection on serologic testing confirm the presence of the HBV.
Herpes simplex virus (HSV)
  • Genital and extragenital lesions can mimic the skin lesions that occur in disseminated gonococcal infection
  • Viral culture, polymerase chain reaction (PCR), and direct fluorescence antibody confirm the presence of the causative agent.
HIV infection
  • Present with generalized rash with mucus membrane involvement, fever, chills, and arthralgia. Joint effusions are uncommon
Gout and other crystal-induced arthritis
  • Presents with acute monoarthritis with fever and chills
  • Synovial fluid analysis confirm the diagnosis.
Lyme disease
  • Present with erythema chronicum migrans rash and monoarthritis as a later presentation.
  • Clinical characteristics of the rash and and serologic testing confirm the diagnosis.

Other Differentials

AIDS should be differentiated from other conditions presenting with fever, fatigue, weight loss, arthralgia, myalgia, rash and soft tissue swelling. The differentials include the following:[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]

Category of Disease Diseases Signs and symptoms Laboratory findings
Fever Fatigue Arthralgia Myalgia Soft tissue swelling/serositis Skin rash Weight loss Dyspnea Sore throat Lymphadenopathy Complete blood count (CBC) Liver function tests (LFTs)

Inflammatory markers

Autoantibodies

Diagnostic tests

Erythrocyte sedimentation rate (ESR) C- reactive protein (CRP) Anti-nuclear antibodies (ANA) Rheumatoid factor (RF) Anti- glomerular basement membrane (anti-GBM) Anti-dsDNA Anti-Jo1/ Anti Mi2 ANCA

Infections

 HIV + + + + +/- - + +/- + /- + - - - - - -
 Herpesviridae + + + + + - - +/- + - - - - - - -
 Measles + + + + - - - + + - - - - - - -
 Viral hepatitis + + - +/- - - +/- - - +/- - - - - - -
 Parvovirus B19 + + + +/- -
  • Slapped cheek rash
- - - + - - - - - -
Infective endocarditis + + + +/- - +/- + - + - - - - - - - Blood cultures, ultrasonography
Borreliosis, Brucellosis, Yersiniosis + + + + - - - - + - - - - - - Serology, PCR
Syphilis and Jarisch-Herxheimer reaction + + + + - - - + +
  • ALT (Uncommon)
  • AST (Uncommon)
- - - - - - Serology, PCR
Toxoplasmosis + + - + - - - + + - - - - - - Serology, PCR

Neoplasia

Malignant lymphoma + + - +/- +/- + + - + - - - - - - CT, PET/CT, Bone marrow examination, lymph node biopsy
Multicentric Castleman disease + + - - + - + + - + - - - - - - - Lymph node biopsy
Angioimmunoblastic T cell lymphoma + + - - - + - - + - - - - - - Lymph node biopsy

Drug hypersensitivity

Drug reaction with eosinophilia and systemic symptoms + + + + +/- - + - - - - - - - - - Eosinophil count, skin biopsy

Autoimmune conditions

Systemic lupus erythematosus + + + +/- + + + - +/- + + - + - - Antinuclear autoantibodies
Inflammatory myositis + + - + (weakness > pain) -
  • Macular red rash over the back of the fingers, elbows or knees (Grotton's sign)
  • Macular purpish or reddish rash on the upper chest or back  (Shawl-like, heliotrope rash)
- - - +/- - +/- +/- - - + - Idem, muscle biopsy
Rheumatoid arthritis + + + - + - + - + - +/- +/- - - - - Anti-citrullinated peptids autoantibodies, rheumatoid factor
Systemic vasculitides + + + - + - +/- - +/- - - - +/- - - + ANCA, tissue biopsy, arteriography
Familial Mediterranean fever + + + + + + + (due to pain) - +/- - - - - - - - Familial history, MEFV gene analysis
Mevalonate kinase deficiency + + + + - + - + + - - - - - - - Urinary mevalonic acid, mevalonate kinase analysis
Reactive arthritis + + + - - - + (Aortic insufficiency) - + - - - - - - - HLA B27, magnetic resonance imaging

Miscellaneous

Sarcoidosis + + + - + + + - +
  • Normal ALT, AST
  • ALP ↑ (infiltrative pattern)
- - - - - -
  • Lymph node/Lung biopsy
  • ACE levels
  • FDG-PET

References

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  2. "National Cancer Institute - Cancers In Young People".
  3. Morrison VA (2014). "Immunosuppression associated with novel chemotherapy agents and monoclonal antibodies". Clin Infect Dis. 59 Suppl 5: S360–4. doi:10.1093/cid/ciu592. PMID 25352632.
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  9. Gøransson LG, Omdal R, Husby G (March 1992). "[Adult-onset Still's disease. Diagnosis, differential diagnosis and treatment]". Tidsskr. Nor. Laegeforen. (in Norwegian). 112 (9): 1155–5. PMID 1579936.
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  15. Aucott JN, Crowder LA, Yedlin V, Kortte KB (2012). "Bull's-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans". Dermatol Res Pract. 2012: 451727. doi:10.1155/2012/451727. PMC 3485866. PMID 23133445.
  16. Karaali Z, Baysal B, Poturoglu S, Kendir M (May 2011). "Cutaneous manifestations in brucellosis". Indian J Dermatol. 56 (3): 339–40. doi:10.4103/0019-5154.82505. PMC 3132922. PMID 21772606.
  17. La Spada E, Micalizzi A, La Spada M, Quartarano P, Nugara G, Soresi M, Affronti M, Montalto G (September 2008). "[Abnormal liver function in brucellosis]". Infez Med (in Italian). 16 (3): 148–53. PMID 18843212.
  18. French P (January 2007). "Syphilis". BMJ. 334 (7585): 143–7. doi:10.1136/bmj.39085.518148.BE. PMC 1779891. PMID 17235095.
  19. "Syphilis: Review with Emphasis on Clinical, Epidemiologic, and Some Biologic Features".
  20. Baveja S, Garg S, Rajdeo A (March 2014). "Syphilitic hepatitis: an uncommon manifestation of a common disease". Indian J Dermatol. 59 (2): 209. doi:10.4103/0019-5154.127711. PMC 3969699. PMID 24700957.
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  23. Furtado JM, Smith JR, Belfort R, Gattey D, Winthrop KL (July 2011). "Toxoplasmosis: a global threat". J Glob Infect Dis. 3 (3): 281–4. doi:10.4103/0974-777X.83536. PMC 3162817. PMID 21887062.
  24. Ripert C (March 2000). "[Reactive hypereosinophilia in parasitic diseases]". Rev Prat (in French). 50 (6): 602–7. PMID 10808314.
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  26. Han T, Stutzman L (July 1967). "Mode of spread in patients with localized malignant lymphoma". Arch. Intern. Med. 120 (1): 1–7. PMID 5339237.
  27. Saeed-Abdul-Rahman I, Al-Amri AM (September 2012). "Castleman disease". Korean J Hematol. 47 (3): 163–77. doi:10.5045/kjh.2012.47.3.163. PMC 3464333. PMID 23071471.
  28. Saeed-Abdul-Rahman I, Al-Amri AM (September 2012). "Castleman disease". Korean J Hematol. 47 (3): 163–77. doi:10.5045/kjh.2012.47.3.163. PMC 3464333. PMID 23071471.
  29. Papadavid E, Panayiotides I, Dalamaga M, Katoulis A, Economopoulos T, Stavrianeas N (2010). "Cutaneous involvement in angioimmunoblastic T-cell lymphoma". Indian J Dermatol. 55 (3): 279–80. doi:10.4103/0019-5154.70704. PMC 2965920. PMID 21063526.
  30. Brockow K, Przybilla B, Aberer W, Bircher AJ, Brehler R, Dickel H, Fuchs T, Jakob T, Lange L, Pfützner W, Mockenhaupt M, Ott H, Pfaar O, Ring J, Sachs B, Sitter H, Trautmann A, Treudler R, Wedi B, Worm M, Wurpts G, Zuberbier T, Merk HF (2015). "Guideline for the diagnosis of drug hypersensitivity reactions: S2K-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Dermatological Society (DDG) in collaboration with the Association of German Allergologists (AeDA), the German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Contact Dermatitis Research Group (DKG), the Swiss Society for Allergy and Immunology (SGAI), the Austrian Society for Allergology and Immunology (ÖGAI), the German Academy of Allergology and Environmental Medicine (DAAU), the German Center for Documentation of Severe Skin Reactions and the German Federal Institute for Drugs and Medical Products (BfArM)". Allergo J Int. 24 (3): 94–105. doi:10.1007/s40629-015-0052-6. PMC 4479479. PMID 26120552.
  31. Medlej-Hashim M, Loiselet J, Lefranc G, Mégarbané A (2004). "[Familial Mediterranean Fever (FMF): from diagnosis to treatment]". Sante (in French). 14 (4): 261–6. PMID 15745878.
  32. Zhang S (May 2016). "Natural history of mevalonate kinase deficiency: a literature review". Pediatr Rheumatol Online J. 14 (1): 30. doi:10.1186/s12969-016-0091-7. PMC 4855321. PMID 27142780.

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