What is the role of oral rehydration solution (ORS) for acute infectious diarrhea? ORS has revolutionized the treatment of acute infectious diarrhea worldwide. ORS takes advantage of the fact that sodium and glucose are cotransported in the jejunum, a mechanism unaffected by pathologic increases in intestinal secretion that leads to enhanced water absorption. The use …
How is C difficile infection treated The first treatment for C. difficile infection is to stop any offending antibiotics, if possible. If symptoms persist, treatment depends on the clinical context. For mild to moderate infections, oral metronidazole (500 mg tid for 10-14 days) remains the agent of choice. In severe infection (two or more points based on the …
When is a test of cure necessary for acute infectious diarrhea? In most cases of acute infectious diarrhea, resolution of symptoms is enough. There are no indications for tests of cure with C. difficile in patients whose symptoms have resolved. Many health departments require that restaurant workers with Salmonella infections have a stool test to demonstrate that they are …
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What is the best test to evaluate for Clostridium difficile infection? Traditionally, the diagnosis of C. difficile infection was based on EIA tests and confirmatory toxigenic cultures or cytotoxic assays. The limited sensitivity of EIA tests, along with the time and labor requirements of the confirmatory tests, prompted the development of more rapid and reliable tests. PCR tests have …
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When should one be concerned about a systemic infection from a nonenteric pathogen in a patient presenting with diarrhea? Most enteric pathogens present with a diarrhea-predominant clinical syndrome, although other symptoms (headache, myalgias, fever, and malaise) may also be present. Most of these infections are self-limited and resolve within a few days. Those that can …
Should endoscopy be considered to evaluate acute infectious diarrhea? Endoscopy should not be part of the routine evaluation of acute diarrhea, but can be considered in a select number of situations. Endoscopy may be useful to evaluate for IBD in patients with persistent bloody diarrhea and a negative infectious workup who do not respond to …
How to differentiate IBD from acute infectious diarrhea? The initial presentation of IBD can sometimes be difficult to distinguish from some forms of acute infectious diarrhea. IBD can be considered in patients with persistent bloody diarrhea (> 7 days) with a negative infectious workup and lack of response to empiric therapy. Suspicion for IBD is …
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