Acute Diarrhea Evaluation in Primary Care Acute Diarrhea luation in ...

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Pathogenesis of viralinduced diarrhea • Inflammation minimal, or patchy • Involves upper 2/3 of villus membrane • (brush border) • Rotavirus best studied; • NSP4 protein—viral plus enterocyte • contribution—viruscell cell interaction. Increase in intra • cellular calcium promotes chloride secretion. • disaccharidases inhibited • SCLT1 inhibited (=malabsorption of CHO) • epithelial cell cytoskeleton altered (distortion of • chemical and osmotic gradients) • cytokinelike peptides (from host as well as virus)
Traveller’s diarrhea • Usually 36 days after arrival in new • country • Central America>Africa>SE Asia>Asia • Most from entertoxigenic E.coli • Rotavirus accounts for 10% • Clostridium difficile also common • Parasites (except giardia) rare • 5 days – 3 weeks is usual course • High incidence of postinfectious FBDz
Page 1 and 2: Acute Diarrhea Evaluation in Primar
Page 3 and 4: Definition— —”Acute” • Pa
Page 5 and 6: Initial Evaluation • Evaluation p
Page 7 and 8: Initial evaluationdiagnostic poss
Page 9 and 10: Food Poisoning Syndromes • Prefor
Page 11 and 12: GI disease not related to food •
Page 13 and 14: Gastroenteritis syndromes • Emesi
Page 15 and 16: Calicivirus • 90% of epidemic gas
Page 17: Rotavirus • Major illness in very
Page 21 and 22: Foodrelated gastrointestinal infe
Page 23 and 24: salmonella • Most common foodbo
Page 25 and 26: Salmonella (continued) • Treatmen
Page 27 and 28: E.coli O157:H7 (Enterohemorrhargic
Page 29 and 30: Campylobacter jejuni • Common; ra
Page 31 and 32: Clostridium difficile • No longer

Acute Diarrhea Evaluation in Primary Care Acute Diarrhea luation in ...

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