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Infectious Mimics of Inflammatory Bowel Disease
1Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, New York.
Abstract:
Distinguishing inflammatory bowel disease (IBD) from its mimics remains a diagnostic challenge for surgical pathologists. Several gastrointestinal infections produce inflammatory patterns that overlap with typical findings of IBD. Although stool culture, PCR, and other clinical assays may identify infectious enterocolitides, these tests may not be performed or the results may be unavailable at the time of histologic evaluation. Furthermore, some clinical tests, including stool PCR, may reflect past exposure rather than an ongoing infection. It is important for surgical pathologists to be knowledgeable about infections that simulate IBD to generate an accurate differential diagnosis, perform appropriate ancillary studies, and prompt clinical follow-up. This review covers bacterial, fungal, and protozoal infections in the differential diagnosis of IBD.
Insights
Distinguishing inflammatory bowel disease (IBD) from mimics is challenging. Pathologists must recognize infections mimicking IBD for accurate diagnosis and patient care.
Area of Science:
- Gastroenterology
- Pathology
- Infectious Diseases
Background:
- Distinguishing inflammatory bowel disease (IBD) from its mimics presents a diagnostic challenge for surgical pathologists.
- Gastrointestinal infections can exhibit inflammatory patterns that overlap with typical IBD findings.
- Clinical assays for infections may be unavailable or inconclusive at the time of histologic evaluation.
Purpose of the Study:
- To review bacterial, fungal, and protozoal infections that can mimic IBD.
- To enhance surgical pathologists' knowledge of infectious mimics of IBD.
- To aid in generating accurate differential diagnoses and guiding clinical follow-up.
Main Methods:
- Literature review of infectious enterocolitides.
- Analysis of histologic patterns overlapping with IBD.
- Discussion of diagnostic challenges and ancillary studies.
Main Results:
- Several bacterial, fungal, and protozoal infections can present with histologic features similar to IBD.
- Clinical test results may not always be timely or indicative of current infection.
- Knowledge of these mimics is crucial for accurate pathological assessment.
Conclusions:
- Surgical pathologists need awareness of infections that simulate IBD.
- Accurate differential diagnosis requires considering infectious etiologies.
- Prompt clinical follow-up is essential when IBD mimics are suspected.
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