Differential Diagnosis for Diarrhea with Elevated WBC, Eosinophils, Neutrophils, and Monocytes
- Single Most Likely Diagnosis
- Inflammatory bowel disease (IBD): This condition, which includes Crohn's disease and ulcerative colitis, is characterized by chronic inflammation of the gastrointestinal tract, often presenting with diarrhea, elevated white blood cell count (WBC), and increased levels of various WBC subsets including eosinophils, neutrophils, and monocytes due to the inflammatory process.
- Other Likely Diagnoses
- Infectious gastroenteritis: Certain bacterial, viral, or parasitic infections can cause an increase in WBCs, including eosinophils, neutrophils, and monocytes, in response to the infection. The presence of diarrhea is a common symptom.
- Parasitic infections (e.g., giardiasis, amoebiasis): These infections can lead to an increase in eosinophils and other WBCs as part of the body's immune response, along with gastrointestinal symptoms like diarrhea.
- Food allergy or intolerance: Allergic reactions to food can cause an increase in eosinophils and may lead to gastrointestinal symptoms, including diarrhea.
- Do Not Miss Diagnoses
- Clostridioides difficile infection: Although it may not always present with elevated eosinophils, C. difficile infection is a critical diagnosis to consider in cases of diarrhea, especially in hospitalized patients or those with recent antibiotic use, due to its potential severity and treatment implications.
- Ischemic bowel disease: This condition can present with abdominal pain, diarrhea, and elevated WBCs, including neutrophils and monocytes, due to bowel ischemia. It's a medical emergency that requires prompt diagnosis and treatment.
- Rare Diagnoses
- Eosinophilic gastroenteritis: A rare condition characterized by the infiltration of eosinophils into the gastrointestinal wall, leading to symptoms like diarrhea, abdominal pain, and weight loss.
- Whipple's disease: A rare, systemic bacterial infection that can cause malabsorption, diarrhea, weight loss, and an increase in WBCs, including monocytes, due to the infection.
- Lymphoma: Certain types of lymphoma, particularly those involving the gastrointestinal tract, can present with diarrhea, weight loss, and elevated WBCs, including lymphocytes and other subsets.