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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Cryptosporidiosis differential diagnosis

Introduction

Overview

Overview

Cryptosporidiosis primarily presents with diarrheasandhould bethus differentiated from other causes of diarrhea which can be viral, bacterial or parasitic.

Differential Diagnosis

Differential Diagnosis

Organism Age predilection Travel History Incubation Size (cell) Incubation Time History and Symptoms Diarrhea type∞ Food source Specific consideration
Fever N/V Cramping Abd Pain Small Bowel Large Bowel Inflammatory Non-inflammatory
Viral Rotavirus <2 y – <102 <48 h + + – + + – Mostly in day cares, most common in winter.
Norovirus Any age – 10 -103 24-48 h + + + + + – Most common cause of gastroenteritis, abdominal tenderness,
Adenovirus <2 y – 105 -106 8-10 d + + + + + – No seasonality
Astrovirus <5 y – 72-96 h + + + + + Seafood Mostly during winter
Bacterial Escherichia coli ETEC Any age + 108 -1010 24 h – + + + + – Causes travelers diarrhea, contains heat-labile toxins (LT) and heat-stable toxins (ST)
EPEC <1 y – 10† 6-12 h – + + + + Raw beef and chicken –
EIEC Any ages – 10† 24 h + + + + + Hamburger meat and unpasteurized milk Similar to shigellosis, can cause bloody diarrhea
EHEC Any ages – 10 3-4 d – + + + + Undercooked or raw hamburger (ground beef)  Known as E. coli O157:H7, can cause HUS/TTP.
EAEC Any ages + 1010 8-18 h – – + + + – May cause prolonged or persistent diarrhea in children
Salmonella sp. Any ages + 1 6 to 72 h + + + + + Meats, poultry, eggs, milk and dairy products, fish, shrimp, spices, yeast, coconut, sauces, freshly prepared salad. Can cause salmonellosis or typhoid fever.
Shigella sp. Any ages – 10 – 200 8-48 h + + + + + Raw foods, for example, lettuce, salads (potato, tuna, shrimp, macaroni, and chicken) Some strains produce enterotoxin and Shiga toxin similar to those produced by E. coli O157:H7
Campylobacter sp. <5 y, 15-29 y Р104 2-5 d + + + + + Undercooked poultry products, unpasteurized milk and cheeses made from unpasteurized milk, vegetables, seafood and contaminated water. May cause bacteremia, Guillain-Barr̩ syndrome (GBS), hemolytic uremic syndrome (HUS) and recurrent colitis
Yersinia enterocolitica <10 y – 104 -106 1-11 d + + + + + Meats (pork, beef, lamb, etc.), oysters, fish, crabs, and raw milk. May cause reactive arthritis; glomerulonephritis; endocarditis; erythema nodosum.

can mimic appendicitis and mesenteric lymphadenitis.

Clostridium perfringens Any ages > 106 16 h – – + + + Meats (especially beef and poultry), meat-containing products (e.g., gravies and stews), and Mexican foods. Can survive high heat,
Vibrio cholerae Any ages – 106-1010 24-48 h – + + + + Seafoods, including molluscan shellfish (oysters, mussels, and clams), crab, lobster, shrimp, squid, and finfish. Hypotension, tachycardia, decreased skin turgor. Rice-water stools
Parasites Protozoa Giardia lamblia 2-5 y + 1 cyst 1-2 we – – + + + Contaminated water May cause malabsorption syndrome and severe weight loss
Entamoeba histolytica 4-11 y + <10 cysts 2-4 we – + + + + Contaminated water and raw foods May cause intestinal amebiasis and amebic liver abscess
Cryptosporidium parvum Any ages – 10-100 oocysts 7-10 d + + + + + Juices and milk May cause copious diarrhea and dehydration in patients with AIDS especially with 180 > CD4
Cyclospora cayetanensis Any ages + 10-100 oocysts 7-10 d – + + + + Fresh produce, such as raspberries, basil, and several varieties of lettuce. More common in rainy areas
Helminths Trichinella spp Any ages – Two viable larvae (male and female) 1-4 we – + + + + Undercooked meats More common in hunters or people who eat traditionally uncooked meats
Taenia spp Any ages – 1 larva or egg 2-4 m – + + + + Undercooked beef and pork Neurocysticercosis: Cysts located in the brain may be asymptomatic or seizures, increased intracranial pressure, headache.
Diphyllobothrium latum Any ages – 1 larva 15 d – – – + + Raw or undercooked fish. May cause vitamin B12 deficiency

Cryptosporidiosis 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

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.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]