Differential Diagnosis
- Single most likely diagnosis
- Giardiasis: The patient's symptoms of abdominal pain, dyspepsia, and loose stools, along with the findings of bowel wall thickening, edema in the duodenum and jejunal loops, and raised eosinophil count, are consistent with giardiasis. The empiric therapy started with Ivermectin also supports this diagnosis, as Ivermectin is sometimes used to treat giardiasis.
- Other Likely diagnoses
- Intestinal parasitism (e.g., hookworm, roundworm): The patient's symptoms and raised eosinophil count could also be indicative of other intestinal parasitic infections.
- Inflammatory bowel disease (IBD): The bowel wall thickening and edema in the duodenum and jejunal loops could be consistent with IBD, although the patient's age and lack of other typical IBD symptoms (e.g., weight loss, blood in stool) make this less likely.
- Food poisoning or gastroenteritis: The patient's symptoms of abdominal pain, dyspepsia, and loose stools could be indicative of a foodborne illness or viral gastroenteritis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intussusception: Although less likely, intussusception could cause bowel wall thickening and edema, and would require prompt surgical intervention to prevent complications.
- Mesenteric ischemia: This condition could cause abdominal pain, bowel wall thickening, and edema, and would require prompt diagnosis and treatment to prevent bowel infarction.
- Eosinophilic gastroenteritis: This rare condition could cause raised eosinophil count, bowel wall thickening, and edema, and would require prompt diagnosis and treatment to prevent complications.
- Rare diagnoses
- Whipple's disease: A rare bacterial infection that could cause abdominal pain, diarrhea, and weight loss, although the patient's symptoms and findings are not typical for this condition.
- Abdominal tuberculosis: A rare condition that could cause abdominal pain, bowel wall thickening, and edema, although the patient's symptoms and findings are not typical for this condition.
- Eosinophilic enteritis: A rare condition characterized by eosinophilic infiltration of the intestinal wall, which could cause abdominal pain, diarrhea, and bowel wall thickening.