Acute diarrhoea Flashcards
Definition of diarrhoea
The passage of loose/ watery stools at least 3-4 times a day
Definition of dysentery
Diarrhoea with visible blood
What pathogen is dysentery associated with?
An invasive enteric pathogen
What clinical features is dysentery associated with?
Fever + abdominal pain
2 pathophysiological mechanisms of diarrhoeal disease
- Small bowel disease :shift of electrolytes and water
2. Large bowel: Inflammatory or cytotoxic destruction by invasive organisms
Risk factors for acute diarrhoea
- Poor socio-economic conditions
- Babies and children
- HIV infected
- Hospitalisation
Diarrhoae for <14 days
Acute
Diarrhoea for 14-28 days
Persistent
Diarrhoea for >28 days
Chronic
Which pathogens mainly cause dehydration?
Toxin producers
Which pathogens mainly cause dysentery?
Invasive organisms (those that cause variable and severe inflammation)
What are the indications for further evaluation of acute diarrhoea?
- Profuse diarrhoea +dehydration
- Dysentery
- > 48 hours without improvement
- Recent AB use
- Associated with a community outbreak
- Abdominal pain in patients >50 years
- Elderly (>70) and immunocompromised patients
Cornerstone of diagnostic evaluation of acute diarrhea?
- Microscopy
- Culture
- Immunoassays
- PCR
Management of mild diarrhoea
Fluid alone
Management of severe diarrhoea
Fluid, sugar and electrolytes
When is the use of antisecretory and antimotility agents indicated?
Moderate diarrhoea without fever and dysentery
When are ABs used for acute diarrhoea?
Febrile dysentery present
What organisms are responsible for persistent/ chronic diarrhoea?
Giardia, cryptospordium, Campylobacter, C. difficile
What are the risk factors for persistent/chronic diarrhoea?
- Socio-economic status
- Children <2 years
- Immunocompromised hosts
Management of persistent/ chronic diarrhoea
Correct fluid and electrolytes
AB if leucocytes in stool
Differential diagnosis for chronic/persistent diarrhoae
- Inflammatory bowel disease
- Ca
- Endocrine conditions
- Exotic infections
