Symptom Finder - Acute Diarrhea
DIARRHEA, ACUTE
Acute diarrhea is most likely infectious. Beginning with the smallest organism and working up to the largest will help recall the most common types of infectious diarrhea. The smallest organism prompts the recall of viral gastroenteritis. A midsized organism would suggest Staphylococcus, Salmonella, cholera, botulism, Campylobacter, Escherichia coli, Clostridium difficile, and bacillary dysentery. Moving up to the next
largest organism, one would recall amebic dysentery and giardiasis. Both of these conditions move on to become chronic diarrhea if left untreated.
Patients with acquired immunodeficiency syndrome (AIDS) may have acute diarrhea from cryptosporidiosis. This organism is responsible for worldwide epidemics of diarrhea. Finally, larger organism such as Trichinella spiralis may also be associated
with acute diarrhea.
Acute diarrhea is also caused by many drugs such as antibiotics, colchicine, ethacrynic acid, digitalis, and quinidine. Pseudomembranous enterocolitis is a severe diarrhea that follows antibiotic administration.
Another form of noninfectious acute diarrhea is associated with ulcerative colitis and Crohn disease. This is often characterized by grossly bloody stools.
Approach to the Diagnosis
The history may help differentiate many causes of acute diarrhea. Fever would help to distinguish Salmonella, Shigella, and Campylobacter jejuni.Blood in the stool also suggests Salmonella, Shigella, and Campylobacter, but may also be due to ulcerative colitis, amebic dysentery, or pseudomembranous colitis. If there is no blood in the stool, the patient most likely has viral gastroenteritis, staphylococcal toxin diarrhea, or traveler’s diarrhea. If other members of the family are experiencing the same symptoms, the clinician should look for staphylococcal toxin diarrhea or botulism. Vomiting is associated with toxic staphylococcal gastroenteritis and viral gastroenteritis, but is unlikely with giardiasis and pseudomembranous colitis.
All patients need to provide a stool sample for occult blood, culture, and smear for ovum parasites, and Giardia antigens. If there is a history of antibiotic use, the stool should be tested for C. difficile toxin B.
Other Useful Tests
1. Stool smear for leukocytes
2. Culture for Campylobacter or Yersinia
3. Sigmoidoscopy
4. Colonoscopy
5. Stool for Giardia antigen
6. Swallowed string test (Giardiasis)
Acute diarrhea is most likely infectious. Beginning with the smallest organism and working up to the largest will help recall the most common types of infectious diarrhea. The smallest organism prompts the recall of viral gastroenteritis. A midsized organism would suggest Staphylococcus, Salmonella, cholera, botulism, Campylobacter, Escherichia coli, Clostridium difficile, and bacillary dysentery. Moving up to the next
largest organism, one would recall amebic dysentery and giardiasis. Both of these conditions move on to become chronic diarrhea if left untreated.
Patients with acquired immunodeficiency syndrome (AIDS) may have acute diarrhea from cryptosporidiosis. This organism is responsible for worldwide epidemics of diarrhea. Finally, larger organism such as Trichinella spiralis may also be associated
with acute diarrhea.
Acute diarrhea is also caused by many drugs such as antibiotics, colchicine, ethacrynic acid, digitalis, and quinidine. Pseudomembranous enterocolitis is a severe diarrhea that follows antibiotic administration.
Another form of noninfectious acute diarrhea is associated with ulcerative colitis and Crohn disease. This is often characterized by grossly bloody stools.
Approach to the Diagnosis
The history may help differentiate many causes of acute diarrhea. Fever would help to distinguish Salmonella, Shigella, and Campylobacter jejuni.Blood in the stool also suggests Salmonella, Shigella, and Campylobacter, but may also be due to ulcerative colitis, amebic dysentery, or pseudomembranous colitis. If there is no blood in the stool, the patient most likely has viral gastroenteritis, staphylococcal toxin diarrhea, or traveler’s diarrhea. If other members of the family are experiencing the same symptoms, the clinician should look for staphylococcal toxin diarrhea or botulism. Vomiting is associated with toxic staphylococcal gastroenteritis and viral gastroenteritis, but is unlikely with giardiasis and pseudomembranous colitis.
All patients need to provide a stool sample for occult blood, culture, and smear for ovum parasites, and Giardia antigens. If there is a history of antibiotic use, the stool should be tested for C. difficile toxin B.
Other Useful Tests
1. Stool smear for leukocytes
2. Culture for Campylobacter or Yersinia
3. Sigmoidoscopy
4. Colonoscopy
5. Stool for Giardia antigen
6. Swallowed string test (Giardiasis)
