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 allergy or intolerance: The patient's symptoms of abdominal pain, dyspepsia, and loose stools could be related to a food allergy or intolerance, particularly if the patient has a history of atopic diseases (e.g., asthma, eczema).
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Intestinal obstruction: Although the patient's symptoms do not strongly suggest intestinal obstruction, the presence of bowel wall thickening and edema in the duodenum and jejunal loops warrants consideration of this potentially life-threatening condition.
- Infectious enteritis (e.g., bacterial, viral): The patient's symptoms and findings could be consistent with infectious enteritis, which can be severe and even life-threatening if not promptly treated.
- Rare diagnoses
- Eosinophilic gastroenteritis: This rare condition is characterized by eosinophilic infiltration of the gastrointestinal tract and can present with symptoms similar to those experienced by the patient.
- Tropical sprue: This rare condition is characterized by malabsorption and can present with symptoms similar to those experienced by the patient, although it is typically associated with travel to tropical regions.