Gastroenteritis: Difference between revisions

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(Created page with "== Background == * Rapid-onset diarrheal illness usually lasting less than 2 weeks == Clinical Manifestations == {| class="wikitable" !Species !Incubation !Duration !Risk Fa...")
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== Background ==
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==Background==
   
βˆ’
* Rapid-onset diarrheal illness usually lasting less than 2 weeks
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*Rapid-onset diarrheal illness usually lasting less than 2 weeks
   
βˆ’
== Clinical Manifestations ==
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==Clinical Manifestations==
 
{| class="wikitable"
  
{| class="wikitable"
 
!Species
  
!Species
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|}
   
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=== Red Flags ===
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=== Extraintestinal Complications ===
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{| class="wikitable"
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! rowspan="2" |Complication
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! colspan="6" |Bacteria
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! colspan="3" |Parasites
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|-
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![[Campylobacter]]
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![[Listeria]]
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![[Salmonella]]
  +
![[Shigella]]
  +
![[STEC]]
  +
![[Yersinia]]
  +
![[Cyclospora]]
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![[Entamoeba]]
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![[Giardia]]
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|-
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|[[Aortitis]]
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|
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|
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| +
  +
|
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|
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| +
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|
  +
|
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|
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|-
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|Deep tissue infection
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|
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|
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| +
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|
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|
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| +
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|
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|
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|
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|-
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|[[Erythema nodosum]]
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| +
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|
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| +
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| +
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|
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| +
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|
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|
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|
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|-
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|[[Glomerulonephritis]]
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| +
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|
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|
  +
| +
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|
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| +
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|
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|
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|
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|-
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|[[Guillain-BarrΓ© syndrome]]
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| +
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|
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|
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|
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|
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|
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|
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|
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|
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|-
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|[[Hemolytic anemia]]
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| +
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|
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|
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|
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|
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| +
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|
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|
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|
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|-
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|[[Hemolytic-uremic syndrome]]
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|
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|
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|
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| +† 
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| +
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|
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|
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|
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|
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|-
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|[[IgA nephropathy]]
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| +
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|
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|
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|
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|
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|-
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|[[Intestinal perforation]]
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| +
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|
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|
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|
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|-
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|[[Meningitis]]
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|
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| +
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| +‑ 
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|
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|
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|
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|
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|-
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|[[Osteomyetlitis]]
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|
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| +
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|
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|-
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|[[Post-infectious irritable bowel syndrome|Post-infectious IBS]]
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|
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| +
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|
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|-
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|[[Reactive arthritis]]
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| +
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|
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| +
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| +
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|
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| +
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|rare
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|
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|rare
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|}
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  +
* †  Shigella dysenteriaea serotype 1
  +
* ‑  infants ≀3 months
  +
  +
===Red Flags===
   
βˆ’
* Duration >1 week
 +
*Duration >1 week
βˆ’
* Fever
 +
*Fever
βˆ’
* Bloody diarrhea
 +
*Bloody diarrhea
βˆ’
* Severe abdominal pain
 +
*Severe abdominal pain
βˆ’
* Dehydration, [[hypovolemia]], shock
 +
*Dehydration, [[hypovolemia]], shock
βˆ’
* Weight loss
 +
*Weight loss
βˆ’
* Recent antibiotic exposure
 +
*Recent antibiotic exposure
βˆ’
* Pregnancy
 +
*Pregnancy
βˆ’
* Age over 65 years
 +
*Age over 65 years
βˆ’
* Diabetes, HIV, or other immunocompromising condition
 +
*Diabetes, HIV, or other immunocompromising condition
   
βˆ’
== Management ==
 +
==Management==
   
βˆ’
* Usually supportive, with a focus on rehydration
 +
*Usually supportive, with a focus on rehydration
βˆ’
** Oral rehydration if tolerating enough oral intake
 +
**Oral rehydration if tolerating enough oral intake
βˆ’
** Intravenous rehydration if not
 +
**Intravenous rehydration if not
   
 
[[Category:Gastrointestinal infections]]
  
[[Category:Gastrointestinal infections]]

Revision as of 19:40, 22 August 2020

Background

  • Rapid-onset diarrheal illness usually lasting less than 2 weeks

Clinical Manifestations

Species Incubation Duration Risk Factors Symptoms
Staphylococcus aureus 1-6 hours 24-48 hours preformed toxin in unrefrigerated food watery diarrhea, with prominent vomiting
Bacillus cereus 1-6 hours 24-48 hours preformed toxin in unrefrigerated food watery diarrhea, with prominent vomiting
Norovirus 24-48 hours 48-72 hours molluscs, shellfish, leafy vegetables, fruit, sandwiches watery diarrhea, with prominent vomiting
Rotavirus 24-48 hours 48-72 hours molluscs, shellfish, leafy vegetables, fruit, sandwiches watery diarrhea, with prominent vomiting
Clostridium perfringens 8-16 hours 24-48 hours meat, poulty, canned food watery diarrhea
Enteric viruses, including rotavirus, adenovirus, astrovirus, and sapovirus 10-16 hours 2-9 days contaminated food or water watery diarrhea
Listeria monocytogenes 24 hours variable processed meats, hot dogs, soft cheese, pΓ’tΓ©s, and fruit watery diarrhea
Enterotoxigenic Escherichia coli 1-3 days 2-3 days contaminated food or water watery diarrhea
Nontyphoidal Salmonella 1-3 days 1-7 days poultry, eggs, fresh produce, meat, fish, unpasteurized juice or milk inflammatory diarrhea, dysentery
Campylobacter species 1-3 days 5-14 days poultry, meat, unpasteurized milk inflammatory diarrhea, dysentery
Shigella species 1-3 days 2-3 days raw vegetables, MSM inflammatory diarrhea, dysentery
Enterohemorrhagic Escherichia coli 1-8 days 1 week ground beef or other meat, fresh produce, unpasteurized milk and juice inflammatory diarrhea, dysentery
Yersinia species 4-6 days 1-3 weeks pork, untreated water inflammatory diarrhea, dysentery
Giardia lamblia 7-14 days days to weeks contaminated food or water watery diarrhea
Cyclospora cayetanensis 1-11 days weeks herbs and berries watery diarrhea
Cryptosporidium parvum 2-28 days weeks vegetables, fruit, unpasteurized milk watery diarrhea
Clostridioides difficile β€” variable antibiotics, PPI use watery or inflammatory diarrhea

Extraintestinal Complications

Complication Bacteria Parasites
Campylobacter Listeria Salmonella Shigella STEC Yersinia Cyclospora Entamoeba Giardia
Aortitis + +
Deep tissue infection + +
Erythema nodosum + + + +
Glomerulonephritis + + +
Guillain-BarrΓ© syndrome +
Hemolytic anemia + +
Hemolytic-uremic syndrome +†  +
IgA nephropathy +
Intestinal perforation + + + + +
Meningitis + +‑ 
Osteomyetlitis + +
Post-infectious IBS + + + + +
Reactive arthritis + + + + rare rare
  • †  Shigella dysenteriaea serotype 1
  • ‑  infants ≀3 months

Red Flags

  • Duration >1 week
  • Fever
  • Bloody diarrhea
  • Severe abdominal pain
  • Dehydration, hypovolemia, shock
  • Weight loss
  • Recent antibiotic exposure
  • Pregnancy
  • Age over 65 years
  • Diabetes, HIV, or other immunocompromising condition

Management

  • Usually supportive, with a focus on rehydration
    • Oral rehydration if tolerating enough oral intake
    • Intravenous rehydration if not
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