Acute diarrhea Flashcards
1
Q
Timeline that separates acute from chronic diarrhea?
A
4 weeks
2
Q
Ddx
A
- infectious (viral, bacterial, parasitic)
- medications
- IBD
- ischemia
3
Q
key features to elicit in history
A
- daycare exposure
- NH or SNF exposure
- recent hospitalizations/IV antibiotics
- receptive anal intercourse (STIs)
- travel/camping
4
Q
indications for C. diff testing?
A
-recent abx, hospitlization, chemotherapy, immunosuppression
5
Q
inidcation for fecal WBC
A
-mod-severe diarrhea with inflammatory symptoms
6
Q
indication for FOBT
A
-mod-severe diarrhea with inflammatory symptoms
7
Q
stool culture indication?
A
-only if DEFINITE fever, fecal WBC/FOBT +, or persistence of diarrhea not already treated w/ ABx
8
Q
stool ova + parasites indication?
A
- MSM
- HIV
- > 2 wks of bloody diarrhea
- travel or infant daycare exposure
9
Q
Mx of non-inflammatory acute diarrhea?
A
- supportive with hydration
- loperamide
- self limiting
10
Q
Mx of inflmmatory diarrhea
A
Empiric ciprofloxacin 500mg BID x 3-5d IF:
- > 50y or immunocompromised
- fever of 102F
- severe dysentery
- sx > 1wk
- severe dehydration
typically discouraged as most community acquired diarrhea is viral, not shortened by antibiotics
11
Q
selective antibiotics per suspected organism
- Shigella
- Campylobacter
- Giardia
- Salmonella
A
- Shigella: bactrim
- campylbocater: macrolide
- Giardia: flagyl
- Salmonella: bactrim (severe disease, age >50, or CAD)
