What causes acute diarrhea syndromes

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

PresentationEstimated Prevalence (%)Developed CountriesDeveloping Countries
Acute watery diarrhea90Viral, preformed toxinsEnterotoxigenic E. coli , other diarrheogenic E. coli C. jejuni, Salmonella, Shigella
Acute dysentery5-10Shigella , enteroinvasive E. coli CampylobacterShigella , enteroinvasive E. coli C. jejuni, E. histolytica
Persistent diarrhea (> 2 wk)3-4Enteropathogenic E. coli Giardia Yersinia, CampylobacterEnteropathogenic E. coli Giardia
Large voluminous/rice-water stool1Salmonella , enterotoxigenic E. coliVibrio cholerae , enterotoxigenic E. coli
Hemorrhagic colitis< 1Enterohemorrhagic E. coli, STECEnterohemorrhagic E. coli

STEC, Shiga toxin–producing E. coli .


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