Differentials
Infectious diarrhoea
SIGNS / SYMPTOMS
Differential diagnosis is broad as various bacteria, parasites, and viruses cause diarrhoea.[31]
INVESTIGATIONS
Presence of specific infectious agent on stool or serological testing.
Ulcerative colitis
SIGNS / SYMPTOMS
Absence of history of travel to endemic areas.
Bloody diarrhoea.
INVESTIGATIONS
Stool and antigen testing negative for infectious agents.
Typical colonoscopy and biopsy appearance.
Pyogenic liver abscess
SIGNS / SYMPTOMS
Occurs predominantly in females.
Jaundice is more common with pyogenic liver abscess than with amoebic liver abscess.
Associated with hepatobiliary disease.
INVESTIGATIONS
Infective organism identified in blood or pus culture.
Necrotic hepatoma
SIGNS / SYMPTOMS
Absence of history of travel to endemic areas or diarrhoea.
INVESTIGATIONS
Aspirate of hepatoma negative for infectious cause.
Fascioliasis (liver flukes)
SIGNS / SYMPTOMS
There are no physical differentiating characteristics.
INVESTIGATIONS
Key diagnostic test is positive serum antibody for fascioliasis.
Eosinophilia.
Echinococcal liver cyst
SIGNS / SYMPTOMS
There may be no clinical features of an echinococcal liver cyst (which is sometimes an incidental finding in a patient not presenting with abdominal complaints). It may present with anaphylaxis caused by spillage of cyst contents into the peritoneum.
INVESTIGATIONS
Positive serum antibody test for echinococcus.
Aspiration of cyst should be avoided because of the possibility of anaphylaxis.
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