Microsporidiosis differential diagnosis: Difference between revisions

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! style="background: #4479BA; color:#FFF;  width: 200px;" | Laboratory or radiological findings
! style="background: #4479BA; color:#FFF;  width: 200px;" | Laboratory or radiological findings
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Acute viral nasopharyngitis<ref name="pmid12517470">{{cite journal |vauthors=Heikkinen T, Järvinen A |title=The common cold |journal=Lancet |volume=361 |issue=9351 |pages=51–9 |year=2003 |pmid=12517470 |doi=10.1016/S0140-6736(03)12162-9 |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Chronic giardiasis
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* Symptoms start with [[sore throat]]
 
* [[Nasal congestion]] and [[runny nose]]
* [[Cough]] that may persist after the resolution of the other symptoms
* [[Fever]] is not common
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* [[Nasal mucosa]] is [[congested]] and [[Hyperaemia|hyperemic]]
 
* [[Pharynx]] is typically normal
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* Diagnosis is usually clinical and lab tests are rarely needed
 
* The virus can be [[Culture medium|cultured]] on human lung cells but results take time
* [[PCR]] is rapid and accurate test but done only in [[immunocompromised]] patients when the [[virus]] strain needs to be known
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Allergic rhinitis<ref name="pmid20232579">{{cite journal |vauthors=Pawankar R, Bunnag C, Chen Y, Fukuda T, Kim YY, Le LT, Huong le TT, O'Hehir RE, Ohta K, Vichyanond P, Wang DY, Zhong N, Khaltaev N, Bousquet J |title=Allergic rhinitis and its impact on asthma update (ARIA 2008)--western and Asian-Pacific perspective |journal=Asian Pac. J. Allergy Immunol. |volume=27 |issue=4 |pages=237–43 |year=2009 |pmid=20232579 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Cryptosporidiosis
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* Characterized by repeated paroxysms of [[rhinorrhea]], [[sneezing]] and [[cough]].
 
* Symptoms may be related to a specific season of the year, hence the name “seasonal allergies”.
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* [[Rhinorrhea]] fluid is usually clear and watery.
 
* Examination of the nose reveals a crease below the [[nasal bridge]] from repeated pulling of the nose secondary to irritation.
* [[Edema]] in the area below the eye if associated [[conjunctivitis]] is present.<ref name="pmid11449200">{{cite journal |vauthors=Skoner DP |title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis |journal=J. Allergy Clin. Immunol. |volume=108 |issue=1 Suppl |pages=S2–8 |year=2001 |pmid=11449200 |doi= |url=}}</ref>
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* Skin testing using intradermal prick skin tests to determine the specific [[allergens]] causing [[allergic rhinitis]].
 
* Serum immune assays to determine [[IgE|IgE levels]] in the [[serum]].
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Acute sinusitis<ref name="pmid9347786">{{cite journal |vauthors=Low DE, Desrosiers M, McSherry J, Garber G, Williams JW, Remy H, Fenton RS, Forte V, Balter M, Rotstein C, Craft C, Dubois J, Harding G, Schloss M, Miller M, McIvor RA, Davidson RJ |title=A practical guide for the diagnosis and treatment of acute sinusitis |journal=CMAJ |volume=156 Suppl 6 |issue= |pages=S1–14 |year=1997 |pmid=9347786 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Cystoisosporiasis (isosporiasis)
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* Presents with symptoms similar to [[URTI|URTIs]] ([[sneezing]], [[cough]] and [[runny nose]])
 
* Symptoms last for a longer time (about 10 days) with the peak of symptoms between 4th and 6th days.
* Usually, [[acute sinusitis]] is not associated with [[fever]]<ref name="pmid7242607">{{cite journal |vauthors= |title=Acute maxillary sinusitis |journal=N. Engl. J. Med. |volume=305 |issue=4 |pages=226–7 |year=1981 |pmid=7242607 |doi=10.1056/NEJM198107233050419 |url=}}</ref>
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* Inspection may show [[erythema]] and [[edema]] over the involved [[sinus]]
 
* Palpation of [[sinuses]] shows [[tenderness]] on palpation
* [[Transillumination]] of the sinuses may show opacity.
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* [[X ray]] and [[CT]] may show air fluid level or bubbles in the affected sinus.
 
* [[Culture medium|Culture]] of the nasal secretions is of limited use in [[acute sinusitis]] as nasal secretions may be contaminated by [[Flora|nasal flora]].
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Infectious mononucleosis<ref name="pmid4864269">{{cite journal |vauthors=Niederman JC, McCollum RW, Henle G, Henle W |title=Infectious mononucleosis. Clinical manifestations in relation to EB virus antibodies |journal=JAMA |volume=203 |issue=3 |pages=205–9 |year=1968 |pmid=4864269 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Tropical sprue
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* Symptoms of [[pharyngitis]]: [[sore throat]] and [[Dysphagia|difficult swallowing]]
 
* [[Fever]]
* [[Fatigue]]
* [[Lymphadenopathy]] especially in the posterior cervical region
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* Abdominal examination reveals [[splenomegaly]]
 
* [[Maculopapular rash]] may be present
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* Positive monospot test
 
* Elevated [[liver enzymes]]
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==References==
==References==

Revision as of 15:30, 29 June 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Ogheneochuko Ajari, MB.BS, MS [2];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [3]

Overview

Microsporidiosis should be differentiated from other conditions that cause chronic diarrhea in immunocompromised patients.

Differentiating Microsporidiosis from other Diseases

Differential Diagnosis

Disease History Physical examination Laboratory or radiological findings
Chronic giardiasis
Cryptosporidiosis
Cystoisosporiasis (isosporiasis)
Tropical sprue

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