Chapter 13 DIARRHEA, ACUTE Theodore X. O’Connell General Discussion The term diarrhea refers to an increase in the frequency, fluidity, or volume of bowel movements relative to the usual habit of an individual. The World Health Organization (WHO) defines diarrhea as the passage of three or more loose or watery stools per day. An acute diarrheal illness typically is defined as a duration of 5 days or less. Children younger than 5 years old in developing countries have three to nine diarrheal illnesses per year, whereas in North America, young children have on average two diarrheal episodes per year. Acute viral gastroenteritis is the most common cause of acute gastroenteritis in developed countries. Of the viral agents, rotavirus is the most common. Other common causes of diarrhea are bacterial infections, systemic nongastrointestinal infection, and antibiotics. Potentially life-threatening causes of diarrhea include hemolytic uremic syndrome (HUS), intussusception, pseudomembranous colitis, toxic megacolon, and appendicitis. In contrast to the largely viral causation of gastroenteritis in the United States, diarrhea acquired in developing countries is more frequently bacterial in origin. Escherichia coli (E. coli), the most frequently isolated pathogen, may cause diarrhea of varying types and severity. Enterotoxigenic E. coli usually produces a mild, self-limited illness without significant fever or systemic toxicity, although it may be severe in newborns and infants. Enteroinvasive strains of E. coli cause a more significant illness characterized by fever, systemic symptoms, blood and mucus in the stool, and leukocytosis. Other invasive pathogens include Campylobacter, Shigella, and nontyphoid Salmonella. Aeromonas and noncholera Vibrio spp. are encountered less frequently. Dehydration is the main complication of acute diarrhea. HUS is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure. HUS is strongly associated with Shiga toxin–producing E. coli, although other strains and bacteria have been implicated. Causes of Acute Diarrhea Antibiotic Administration Bacillus cereus–preformed toxin Food poisoning Gastrointestinal (GI) Infection Bacterial • Aeromonas • Campylobacter • Clostridium difficile • E. coli • Salmonella (nontyphoid) • Shigella • Vibrio (noncholera) • Yersinia Parasites • Cryptosporidium parvum • Cyclospora cayetanensis • Entamoeba histolytica Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Gynecomastia Abnormal head size and shape Musculoskeletal pain Seizures Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Pediatrics Jun 18, 2016 | Posted by admin in PEDIATRICS | Comments Off on Diarrhea, acute Full access? Get Clinical Tree
Chapter 13 DIARRHEA, ACUTE Theodore X. O’Connell General Discussion The term diarrhea refers to an increase in the frequency, fluidity, or volume of bowel movements relative to the usual habit of an individual. The World Health Organization (WHO) defines diarrhea as the passage of three or more loose or watery stools per day. An acute diarrheal illness typically is defined as a duration of 5 days or less. Children younger than 5 years old in developing countries have three to nine diarrheal illnesses per year, whereas in North America, young children have on average two diarrheal episodes per year. Acute viral gastroenteritis is the most common cause of acute gastroenteritis in developed countries. Of the viral agents, rotavirus is the most common. Other common causes of diarrhea are bacterial infections, systemic nongastrointestinal infection, and antibiotics. Potentially life-threatening causes of diarrhea include hemolytic uremic syndrome (HUS), intussusception, pseudomembranous colitis, toxic megacolon, and appendicitis. In contrast to the largely viral causation of gastroenteritis in the United States, diarrhea acquired in developing countries is more frequently bacterial in origin. Escherichia coli (E. coli), the most frequently isolated pathogen, may cause diarrhea of varying types and severity. Enterotoxigenic E. coli usually produces a mild, self-limited illness without significant fever or systemic toxicity, although it may be severe in newborns and infants. Enteroinvasive strains of E. coli cause a more significant illness characterized by fever, systemic symptoms, blood and mucus in the stool, and leukocytosis. Other invasive pathogens include Campylobacter, Shigella, and nontyphoid Salmonella. Aeromonas and noncholera Vibrio spp. are encountered less frequently. Dehydration is the main complication of acute diarrhea. HUS is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure. HUS is strongly associated with Shiga toxin–producing E. coli, although other strains and bacteria have been implicated. Causes of Acute Diarrhea Antibiotic Administration Bacillus cereus–preformed toxin Food poisoning Gastrointestinal (GI) Infection Bacterial • Aeromonas • Campylobacter • Clostridium difficile • E. coli • Salmonella (nontyphoid) • Shigella • Vibrio (noncholera) • Yersinia Parasites • Cryptosporidium parvum • Cyclospora cayetanensis • Entamoeba histolytica Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Gynecomastia Abnormal head size and shape Musculoskeletal pain Seizures Stay updated, free articles. Join our Telegram channel Join Tags: Instant Work-ups A Clinical Guide to Pediatrics Jun 18, 2016 | Posted by admin in PEDIATRICS | Comments Off on Diarrhea, acute Full access? Get Clinical Tree
