Presentation
One simple approach is to categorize patients into two groups: those who present with bloody diarrhea and those who present with nonbloody diarrhea ( Table 1 ). 3 – 5 Table 1: Possible causes of acute infectious diarrhea 3 – 5 Agent Nonbloody diarrhea [ncbi.nlm.nih.gov]
Abstract THE PURPOSE of this review is to summarize the present status of antibiotic therapy of diarrhea in infancy and childhood. [pediatrics.aappublications.org]
Trials that evaluated L reuteri had less heterogeneity but risk of bias was present in all included studies. [cochranelibrary.com]
Entire Body System
- Sepsis
Testing should be considered when patients present with diarrhea of more than one day’s duration associated with bloody stools, fever, symptoms of sepsis or evidence of dehydration, recent antibiotic use or underlying immunocompromised state, or when [ncbi.nlm.nih.gov]
Gastrointestinal
- Abdominal Pain
Four studies also included the resolution of associated symptoms (e.g. fewer than two stools/d; formed, yellow/brown stools without mucus; no abdominal pain, vomiting, or fever for the whole day; D'Apuzzo 1982). [cochranelibrary.com]
- Nausea
†1000 mg of azithromycin can cause nausea. Note: C. difficile = Clostridium difficile, E. coli = Escherichia coli. The most common causes of community-acquired, infectious diarrhea are viral and short-lived. [ncbi.nlm.nih.gov]
Workup
Microbiology
- Vibrio Parahaemolyticus
parahaemolyticus Shigella spp Salmonella spp Yersinia spp Aeromonas spp Campylobacter spp E. coli producing Shiga-like toxin (e.g., E. coli O157:H7 and other strains) Shigella spp Salmonella spp Yersinia spp Virus Norovirus Rotavirus Adenovirus Astrovirus [ncbi.nlm.nih.gov]
Treatment
What treatment should be offered? Treatment of infectious diarrhea can be divided into supportive treatment and pathogen-directed treatment. Supportive treatment The mainstay of treatment is oral hydration. [ncbi.nlm.nih.gov]
Some infections do require antimicrobial therapy, and appropriate use of diagnostic tests and treatments may potentially minimize unnecessary costs, decrease adverse events, optimize clinical outcomes, and limit antibiotic resistance. [jamanetwork.com]
Unit of analysis issues For trials with multiple treatment groups but a single control arm (no additional treatment or placebo), we selected the treatment group that was most relevant to contributing to the evidence base for use of a specific probiotic [cochranelibrary.com]
Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. McFarland LV. Am J Gastroenterol. 2006 Apr;101(4):812-22. 15. [passeportsante.net]
Prognosis
[…] resulting in unpredictable sequences (such as a random numbers table or list or computer‐generated random numbers), unclear if a trial was stated to be randomized but no further information was provided, and inadequate when allocation could be related to prognosis [cochranelibrary.com]
Etiology
Most diarrhea in infancy and childhood is not identifiable as bacterial in etiology. [pediatrics.aappublications.org]
Prevention
Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis.BMJ. 2002 Jun 8;324(7350):1361. Review. 9. Szajewska H, Mrukowicz J. [passeportsante.net]
Patients who have acute gastrointestinal illness should be reminded of the importance of hand hygiene as a way to prevent transmission to others. [ncbi.nlm.nih.gov]
Description of the intervention The aims of treatment are to prevent or reverse dehydration, shorten the duration of illness (important for preventing progression to persistent diarrhoea, which is associated with adverse outcomes such as malnutrition) [cochranelibrary.com]