Approach to Diarrhoeal illness Flashcards
acute diarrhoea
<14 days
persistent diarrhoea
more than 14 days
chronic diarrhoea
more than 30 days
blood tests
haemoglobin
urea and creatinine
electrolytes - sodium, K, magnesium
CRP
iron stores
causes of acute infectious watery diarrhoea
norovirus
rotavirus
campylobacter spp.
eschericia coli
causes of acute infectious inflammatory diarrhoea
clostridium deficile
escherichia coli
shigella spp.
positive stool sample
stool samples are only positive in 1-5% of cases
diarrhoea in pregnant women
listeria monocytogenes?
developed symptoms within six hours
performed toxins - staph aureus?
reheated rice
bacillus cereus
post ingestion of pork products
yersinia spp. (usually a few days incubation)
recent antibiotic therapy or hospitalisation
clostridium difficile
acute diarrhoea mananegemtn
most cases are self limiting and do not require antibiotics
fluid and electrolyte replacement
consider antibiotics if:
severe disease
immunosuppressed
significant comorbidities
anti diarrhoeals
not recommended as first line therapy
acute diarrhoea oral rehydration solutions (ORS)
SGLT-1 protein usually unaffected
relies on cotransport of sodium and glucose
pulls water into vascular system
low osmolarity solution recommended
what to test for in persistant diarrhoea
reasonable to test for parasitic organisms if not already done
often need to specifically request ‘ova and parasite’ exam
types of parasites that might be the cause of persistent diarrhoea
giardia (lol sam)
cryptosporidium
entamoeba histolytica
often associated with travel
causes of chronic diarrhoea
resource limited places: chronic bacterial Orr parasitic infections
resource rich areas: functional disorders, inflammatory bowel disease, malabsorption syndromes