What specific unique etiologic factors exist for acute diarrheal illness in immunocompromised hosts? Immunoglobulin A deficiency, human immunodeficiency virus (HIV) and acquired immune deficiency syndrome, organ transplantation, rheumatologic disease on immune-suppressing agents, and chemotherapy all may predispose individuals to enteric infection. These hosts are susceptible to common causes of acute diarrhea but also to agents …
What agents of acute diarrhea are most likely to be acquired from ingestion of raw oysters? Oysters and other filter-feeding organisms, whether farmed or harvested from natural environments, are able to harbor and concentrate enteric pathogens. Both viral and bacterial enteric infections may be acquired by the ingestion of raw oysters. Common pathogens of concern …
Which antibiotic class should be avoided in acute diarrhea acquired by a traveler to southeast Asia? Quinolone resistance is prevalent among Campylobacter strains found in southeast Asia and increasingly elsewhere, with rising incidence in Russia, India, and some eastern European countries. The high rate of resistance to this antibiotic class makes them a poor choice for the …
What are the epidemiologic features and species most commonly associated with shigellosis? Shigella infections in developed countries such as the United States are more commonly associated with Shigella sonnei strains. Shigella flexneri infections are more common in developing countries and are the second most common Shigella species isolated from patients in the United States. Shigella dysenteriae is less common but can cause …
What are the diarrheagenic subtypes of E coli? There are six subtypes of diarrheagenic E. coli: Enterotoxigenic E. coli (ETEC) —notable for toxin production, either heat labile, heat stable, or both, and is the most common cause of travelers’ diarrhea in many developing countries. Diffusely adherent E. coli and enteropathogenic E. coli —common in children of younger than 2 years. Tight adherence to small …
What organisms are most likely to present with bloody diarrhea or acute dysentery? Invasive bacterial pathogens, and to a lesser extent amoebae, are more likely to present with a diarrhea accompanied by fever or dysentery. Among bacterial pathogens Shigella spp., nontyphoid Salmonella, Campylobacter spp., STEC, and EHEC variants are the most common. Entamoeba histolytica, the agent of amebic dysentery, may also …
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What vaccine preventable viral pathogen is a major cause of pediatric diarrhea in developing and developed countries? Rotavirus infection is a major cause of outbreak and sporadic diarrhea worldwide. Among children and older adults, outbreaks of rotavirus diarrhea result in significant morbidity and mortality and on recent surveys are the most common cause of moderate …