Differential Diagnosis for Diarrhea, Abdominal Pain, and Eosinophilia
Single Most Likely Diagnosis
- Parasitic Infection (e.g., Giardiasis, Amoebiasis): This is often the most common cause of diarrhea, abdominal pain, and eosinophilia, especially in individuals who have recently traveled to endemic areas or have a history of exposure to contaminated water or food.
Other Likely Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can present with chronic diarrhea, abdominal pain, and sometimes eosinophilia, particularly during flare-ups.
- Food Allergy or Intolerance: Certain food allergies or intolerances, such as lactose intolerance or celiac disease, can cause similar symptoms, including eosinophilia in the case of an allergic reaction.
- Irritable Bowel Syndrome (IBS): While IBS is less likely to cause eosinophilia, it is a common cause of chronic abdominal pain and diarrhea, and some patients may have elevated eosinophil counts.
Do Not Miss Diagnoses
- Tropical Sprue: A rare condition that can cause malabsorption, diarrhea, and abdominal pain, often associated with travel to tropical regions. Eosinophilia may be present, and missing this diagnosis could lead to significant morbidity.
- Whipple's Disease: A systemic bacterial infection that can cause diarrhea, abdominal pain, and malabsorption. While eosinophilia is not a hallmark, the disease's rarity and potential for severe complications make it a "do not miss" diagnosis.
- Eosinophilic Gastroenteritis: A condition characterized by eosinophilic infiltration of the gastrointestinal tract, leading to symptoms like diarrhea, abdominal pain, and sometimes intestinal obstruction. It is crucial not to miss this diagnosis due to its potential for severe complications.
Rare Diagnoses
- Strongyloidiasis: A parasitic infection caused by Strongyloides stercoralis, which can lead to gastrointestinal symptoms and eosinophilia. It is more common in immunocompromised individuals or those from endemic areas.
- Anisakiasis: An infection caused by the ingestion of Anisakis larvae, often found in undercooked fish. It can cause acute abdominal pain, diarrhea, and eosinophilia.
- Abetalipoproteinemia: A rare genetic disorder affecting fat absorption, which can lead to chronic diarrhea and abdominal pain, though eosinophilia is not a primary feature.