Differential Diagnosis for HIV Patient with Abdominal Pain and Non-Bloody Diarrhea
- Single Most Likely Diagnosis
- CMV (Cytomegalolo Virus) colitis: This is a common cause of diffuse pancolitis in HIV patients with low CD4 counts, presenting with abdominal pain, non-bloody diarrhea, and low leukocytes. CMV colitis is known to cause significant morbidity in immunocompromised patients.
- Other Likely Diagnoses
- Cryptosporidiosis: A common opportunistic infection in HIV patients with low CD4 counts, leading to non-bloody diarrhea and abdominal pain.
- Microsporidiosis: Another opportunistic infection causing non-bloody diarrhea and abdominal pain in immunocompromised patients.
- Mycobacterium-dessaminatum (MAP) infection: Although less common, it can cause abdominal pain, diarrhea, and weight loss in HIV patients with low CD4 counts.
- Do Not Miss Diagnoses
- Ischemic colitis: Although less likely, it's crucial to consider due to its high mortality rate if missed. Ischemic colitis can present with abdominal pain and non-bloody diarrhea.
- Invasive bacterial infections (e.g., Salmonella, Shigella): These can cause severe illness in immunocompromised patients and require prompt diagnosis and treatment.
- Rare Diagnoses
- Tuberculosis: Although rare in the context of diffuse pancolitis, it should be considered in the differential diagnosis, especially in patients from endemic areas.
- Lymphoma: HIV patients are at increased risk of lymph cancers, which can present with abdominal pain and non-bloody diarrhea, although this would be less common than other diagnoses listed.