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15 - Acute Infectious Diarrhea

from Part I - Systems

Published online by Cambridge University Press:  15 December 2009

Kimberly Schertzer
Affiliation:
Simulation Fellow, Stanford University School of Medicine, Stanford, CA, Kaiser Permanente Medical Center, Santa Clara, CA
Gus M. Garmel
Affiliation:
Clinical Associate Professor of Surgery Emergency Medicine, Stanford University School of Medicine, Stanford, CA; Co-Program Director, Stanford/Kaiser Emergency Medicine Residency Program, Senior Staff Emergency Physician Permanente Medical Group, Santa Clara, CA
Rachel L. Chin
Affiliation:
University of California, San Francisco
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Summary

INTRODUCTION

Acute diarrhea, defined as the presence of three or more loose stools per day for less than 2 weeks, is usually self-limited and infectious in etiology. In contrast, chronic diarrhea has a duration of more than 3–4 weeks, is less likely to resolve spontaneously, and is more likely to be mechanical in origin. In general, the pathophysiology of diarrhea is osmotic, secretory, inflammatory, or mechanical. Osmotic diarrhea is the result of poorly absorbed molecules, such as lactulose, that draw water into the intestinal lumen. Inflammatory diarrhea occurs when inflammation of the bowel mucosa causes decreased fluid resorption. Secretory diarrhea occurs when there is an increased amount of fluid secreted into the bowel lumen, usually secondary to the effects of bacterial enterotoxin or other secretagogues on the mucosa. Mechanical diarrhea occurs with increased gut motility and is often seen in irritable bowel disease or following surgery. Acute infectious diarrhea is generally inflammatory, secretory, or a combination of both.

EPIDEMIOLOGY

Infectious diarrhea is among the leading causes of adult mortality worldwide and is the single leading cause of childhood mortality, resulting in the deaths of 1.6 to 2.5 million children every year. In the United States, as many as 375 million episodes of diarrheal illness are estimated to occur annually. Diarrheal illness is responsible for approximately 5% of U.S. emergency department (ED) visits, as well as 900,000 hospitalizations and 6000 deaths each year.

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Publisher: Cambridge University Press
Print publication year: 2008

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References

Banks, J B, Sullo, E J, Carter, L. Clinical inquiries. What is the best way to evaluate and manage diarrhea in the febrile infant? [comment]. J Fam Pract 2004;53(12):996–9.Google Scholar
Beaugerie, L, Petit, J-C. Microbial-gut interactions in health and disease. Antibiotic-associated diarrhoea. Best Pract Res Clin Gastroenterol 2004;18(2):337–52.CrossRefGoogle ScholarPubMed
Casburn-Jones, A C, Farthing, M J G. Management of infectious diarrhoea. Gut 2004;53(2):296–305.CrossRefGoogle ScholarPubMed
Dennehy, P H. Rotavirus vaccines: an update. Curr Opin Pediatr 2005;17(1):88–92.CrossRefGoogle ScholarPubMed
Elmer, G W, McFarland, L V. Biotherapeutic agents in the treatment of infectious diarrhea. Gastroenterol Clin North Am 2001;30(3):837–54.CrossRefGoogle ScholarPubMed
Gendrel, D, Treluyer, J M, Richard-Lenoble, D. Parasitic diarrhea in normal and malnourished children. Fundam Clin Pharmacol 2003;17(2):189–97.CrossRefGoogle ScholarPubMed
Goldsweig, C D, Pacheco, P A. Infectious colitis excluding E. coli O157:H7 and C. difficile. Gastroenterol Clin North Am 2001;30(3):709–33.CrossRefGoogle ScholarPubMed
Goodgame, R W. Viral causes of diarrhea. Gastroenterol Clin North Am 2001;30(3):779–95.CrossRefGoogle ScholarPubMed
Gore, J ISurawicz, C. Severe acute diarrhea. Gastroenterol Clin North Am 2003;32(4):1249–67.CrossRefGoogle ScholarPubMed
Huang, D B, Okhuysen, P C, Jiang, Z D, et al. Enteroaggregative Escherichia coli: an emerging enteric pathogen. Am J Gastroenterol 2004;99(2):383–9.CrossRefGoogle ScholarPubMed
Ilnyckyj, A. Clinical evaluation and management of acute infectious diarrhea in adults. Gastroenterol Clin North Am 2001;30(3):599–609.CrossRefGoogle ScholarPubMed
Kosek, M, Bern, C, Guerrant, R LThe global burden of diarrhoeal disease, as estimated from studies published between 1992 and 2000. Bull World Health Organization 2003;81(3):197–204.Google ScholarPubMed
Kyne, L, Farrell, R J, Kelly, C P. Clostridium difficile. Gastroenterol Clin North Am 2001;30(3):753–77.CrossRefGoogle ScholarPubMed
Lee, S D, Surawicz, C M. Infectious causes of chronic diarrhea. Gastroenterol Clin North Am 2001;30(3):679–92.CrossRefGoogle ScholarPubMed
Mack, D R. Probiotics-mixed messages [comment]. Can Fam Physician 2005;51:1455–7, 1462.Google Scholar
Nataro, J P, Sears, C L. Infectious causes of persistent diarrhea. Pediatr Infect Dis J 2001;20(2):195–6.CrossRefGoogle ScholarPubMed
Ramaswamy, K, Jacobson, K. Infectious diarrhea in children. Gastroenterol Clin North Am 2001;30(3):611–24.CrossRefGoogle ScholarPubMed
Ramzan, N N. Traveler's diarrhea. Gastroenterol Clin North Am 2001;30(3):665–78.CrossRefGoogle ScholarPubMed
Sellin, J H. The pathophysiology of diarrhea. Clin Transplantation 2001;15 Suppl 4:2–10.CrossRefGoogle ScholarPubMed
Seupaul R. Diarrhea. In: Mahadevan, S, Garmel, G, eds, An introduction to clinical emergency medicine: guide for practitioners in the emergency department. Cambridge, UK: Cambridge University Press, 2005:233–9.CrossRefGoogle Scholar
Slotwiner-Nie, P K, Brandt, L J. Infectious diarrhea in the elderly. Gastroenterol Clin North Am 2001;30(3):625–35.CrossRefGoogle ScholarPubMed
Starr, J. Clostridium difficile associated diarrhoea: diagnosis and treatment. BMJ 2005;331(7515):498–501.CrossRefGoogle ScholarPubMed
Steffen, R, Gyr, K. Diet in the treatment of diarrhea: from tradition to evidence [comment]. Clin Infect Dis 2004;39(4):472–3.CrossRefGoogle Scholar
Sullivan, A, Nord, C E. Probiotics and gastrointestinal diseases. J Intern Med 2005;257(1):78–92.CrossRefGoogle ScholarPubMed
Tarr, P I, Gordon, C A, Chandler, W L. Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome. Lancet 2005;365(9464):1073–86.Google ScholarPubMed
Tarr, P I, Neill, M A, Escherichia coli O157:H7. Gastroenterol Clin North Am 2001;30(3):735–51.CrossRefGoogle ScholarPubMed
The Sanford guide to antimicrobial therapy, 36th ed. D N Gilbert et al., eds. Sperryville, VA: Antimicrobial Therapy, 2006.
Thielman, N M, Guerrant, R L. Clinical practice. Acute infectious diarrhea [comment]. N Engl J Med 2004;350(1):38–47.CrossRefGoogle Scholar
Wilhelmi, I, Roman, E, Sanchez-Fauquier, A. Viruses causing gastroenteritis. Clin Microbiol Infect 2003;9(4):247–62.CrossRefGoogle ScholarPubMed
Yates, J. Traveler's diarrhea. Am Fam Physician 2005; 71(11):2095–100.Google ScholarPubMed
Gore, J I, Surawicz, C. Severe acute diarrhea. Gastroenterol Clin North Am 2003 Dec;32(4):1249–67.CrossRefGoogle Scholar
Ilnyckyj, A. Clinical evaluation and management of acute infectious diarrhea in adults. Gastroenterol Clin North Am 2001 Sep;30(3):599–609.CrossRefGoogle Scholar
Talan, D, Moran, G J, Newdow, M, et al. EMERGEncy ID NET Study Group. Etiology of bloody diarrhea among patients presenting to United States emergency departments: prevalence of Escherichia coli O157:H7 and other enteropathogens. Clin Infect Dis 2001 Feb 15; 32(4):573–80.CrossRefGoogle Scholar
Thielman, N M, Guerrant, R L. Clinical practice. Acute infectious diarrhea. N Engl J Med 2004 Jan 1;350(1):38–47.CrossRefGoogle Scholar

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  • Acute Infectious Diarrhea
    • By Kimberly Schertzer, Simulation Fellow, Stanford University School of Medicine, Stanford, CA, Kaiser Permanente Medical Center, Santa Clara, CA, Gus M. Garmel, Clinical Associate Professor of Surgery Emergency Medicine, Stanford University School of Medicine, Stanford, CA; Co-Program Director, Stanford/Kaiser Emergency Medicine Residency Program, Senior Staff Emergency Physician Permanente Medical Group, Santa Clara, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.016
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Acute Infectious Diarrhea
    • By Kimberly Schertzer, Simulation Fellow, Stanford University School of Medicine, Stanford, CA, Kaiser Permanente Medical Center, Santa Clara, CA, Gus M. Garmel, Clinical Associate Professor of Surgery Emergency Medicine, Stanford University School of Medicine, Stanford, CA; Co-Program Director, Stanford/Kaiser Emergency Medicine Residency Program, Senior Staff Emergency Physician Permanente Medical Group, Santa Clara, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.016
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Acute Infectious Diarrhea
    • By Kimberly Schertzer, Simulation Fellow, Stanford University School of Medicine, Stanford, CA, Kaiser Permanente Medical Center, Santa Clara, CA, Gus M. Garmel, Clinical Associate Professor of Surgery Emergency Medicine, Stanford University School of Medicine, Stanford, CA; Co-Program Director, Stanford/Kaiser Emergency Medicine Residency Program, Senior Staff Emergency Physician Permanente Medical Group, Santa Clara, CA
  • Edited by Rachel L. Chin, University of California, San Francisco
  • Book: Emergency Management of Infectious Diseases
  • Online publication: 15 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547454.016
Available formats
×