What presentation and historical features are useful in defining the etiologic factors of acute diarrhea syndromes?
- Host factors (age, immune status, medications, comorbid conditions), geography, and socioeconomic status heavily influence the infectious differential diagnosis of diarrheal illness.
- Diarrhea type, and location of presentation are useful determinants.
- The below table groups the common diarrheal syndromes with epidemiologic features.
Prevalence and Infectious Causes of Common Infectious Diarrhea by Syndrome Type
| Presentation | Estimated Prevalence (%) | Developed Countries | Developing Countries |
|---|---|---|---|
| Acute watery diarrhea | 90 | Viral, preformed toxins | Enterotoxigenic E. coli , other diarrheogenic E. coli , C. jejuni, Salmonella, Shigella |
| Acute dysentery | 5-10 | Shigella , enteroinvasive E. coli , Campylobacter | Shigella , enteroinvasive E. coli , C. jejuni, E. histolytica |
| Persistent diarrhea (> 2 wk) | 3-4 | Enteropathogenic E. coli , Giardia , Yersinia, Campylobacter | Enteropathogenic E. coli , Giardia |
| Large voluminous/rice-water stool | 1 | Salmonella , enterotoxigenic E. coli | Vibrio cholerae , enterotoxigenic E. coli |
| Hemorrhagic colitis | < 1 | Enterohemorrhagic E. coli, STEC | Enterohemorrhagic E. coli |
STEC, Shiga toxin–producing E. coli .
