Microsporidiosis differential diagnosis

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

Microsporidiosis must be differentiated from other diseases that may cause chronic diarrhea, weight loss, and abdominal pain especially in immunocompromised patients.

Disease Prominent clinical findings Laboratory or radiological findings
Chronic giardiasis[1]
Cryptosporidiosis[2]
  • Disease might be asymptomatic or cause gastroenteritis (but without any biliary involvement)
  • Gastroenteritis usually resolves spontaneously within 14 days.
  • Microscopic identification of the organism in the stool: The oocysts appear red on staining with modified acid fast staining
  • PCR: Most specific and sensitive diagnostic tool. PCR is expensive and used in limited cases.
Cystoisosporiasis (isosporiasis)[3]
  • Isospora ova or parasites can be visualized on stool microscopic examination.
  • Upper GI endoscopy may used for excluding other esophageal or gastric disease and obtaining specimens for histopathology.
Tropical sprue[4]

References

  1. Thompson RC (2000). "Giardiasis as a re-emerging infectious disease and its zoonotic potential". Int. J. Parasitol. 30 (12–13): 1259–67. PMID 11113253.
  2. Sánchez-Vega JT, Tay-Zavala J, Aguilar-Chiu A, Ruiz-Sánchez D, Malagón F, Rodríguez-Covarrubias JA, Ordóñez-Martínez J, Calderón-Romero L (2006). "Cryptosporidiosis and other intestinal protozoan infections in children less than one year of age in Mexico City". Am. J. Trop. Med. Hyg. 75 (6): 1095–8. PMID 17172373.
  3. Current WL, Garcia LS (1991). "Cryptosporidiosis". Clin. Microbiol. Rev. 4 (3): 325–58. PMC 358202. PMID 1889046.
  4. Klipstein FA, Schenk EA (1975). "Enterotoxigenic intestinal bacteria in tropical sprue. II. Effect of the bacteria and their enterotoxins on intestinal structure". Gastroenterology. 68 (4 Pt 1): 642–55. PMID 1091526.