Diarrhea

Diarrhea

1. Acute

   • Duration of symptoms is <14 days

2. Persistent (>14 days)

3. Chronic (>4 weeks)

4. History: identifying pathogen

   • Alternative water sources, consumption of raw or undercooked meat, raw seafood (Vibrio), unpasteurized milk (E. coli, Salmonella, campylobacter)
   • Travel to undeveloped area (wide range pathogens)
   • Unwell patient contacts (Shigella, E.coli, Salmonella, Campylobacter, Giardia)
   • Recent hospitalisation or antibiotics (C.difficile)
   • Swimming in fresh water lake, swimming pools (E. coli, Salmonella, Camylobacter, Cryptosporidium)

5. Viral causes

   • Probably the most common cause of infectious diarrhea
   • Rotavirus is a common cause of diarrhea in infants and young children
   • Norovirus is frequently implicated in outbreak situations

6. C. difficile is tha major identifiable cause of antibiotic-associated diarrhea

   • Prevalence of asymptomatic colonization of the bowel ranges from <5% in the community to over 20% in hospitalized patients

7. Listeria monocytogenes

   • Diagnosis requires blood cultures
   • Infection can cause febrile gastroenteritis accompanied by bacteremia and sometimes meningitis

8. Campylobacter

   • Sources of infection
     • Contaminated food or water, in particular undercooked chicken or other meats
   • Incubation period
     • 1 to 10 days (usually 2 to 5 days)
   • Symptoms
     • Watery or bloody diarrhea
     • Abdominal pain and nausea
     • Headache
     • Fever
   • Organism survival
     • Survive better in food under refrigeration than at room temperature
   • Treatment
     • Usually none, but fluids may be given

9. Salmonella

   • Sources of infection
     • Undercooked food e.g. chicken, eggs and meat
   • Incubation period
     • 6-48 hours
   • Symptoms
     • Diarrhea, abdominal pain, vomiting, nausea and fever lasting 1-7 days
   • Organism survival

10. Giardia/Cryptosporidium

    • Treatment
    • Organism survival
    • Symptoms
    • Incubation period
    • Sources of infection

11. E coli 0157:H7

    • Sources of infection
    • Incubation period
    • Symptoms
    • Organism survival
    • Treatment

12. Shigella

    • Treatment
    • Organism survival
    • Symptoms
    • Incubation period
    • Sources of infection

13. Yearsinia

    • Treatment
      • Usually self-limiting, antibiotics do not reduce the severity or duration of the illness
    • Organism survival
    • Symptoms
      • Abdominal pain, diarrhea, nausea and vomiting
      • Headache
      • Fever
    • Incubation period
      • Approximately 7 days
    • Sources of infection