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    DIARRHEAL INFECTIONS Table

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    theonlinegeekhub
    The document discusses different types of acute infections diarrhea including watery vs dysenteric diarrhea. It provides details on stool appearance, mechanisms, complications, etiology, dehydration assessment and recommendations for anti-microbial therapy for various pathogens causing diarrhea.

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    DIARRHEAL INFECTIONS Table

    Uploaded by

    theonlinegeekhub
    12 views8 pages
    The document discusses different types of acute infections diarrhea including watery vs dysenteric diarrhea. It provides details on stool appearance, mechanisms, complications, etiology, dehydration assessment and recommendations for anti-microbial therapy for various pathogens causing diarrhea.

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    DIARRHEAL INFECTIONS table

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    The document discusses different types of acute infections diarrhea including watery vs dysenteric diarrhea. It provides details on stool appearance, mechanisms, complications, etiology, dehydration assessment and recommendations for anti-microbial therapy for various pathogens causing diarrhea.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    12 views8 pages

    DIARRHEAL INFECTIONS Table

    Uploaded by

    theonlinegeekhub
    The document discusses different types of acute infections diarrhea including watery vs dysenteric diarrhea. It provides details on stool appearance, mechanisms, complications, etiology, dehydration assessment and recommendations for anti-microbial therapy for various pathogens causing diarrhea.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 8

    ACUTE INFECTIONS DIARRHEA CLINICAL

    SYNDROMES: WATERY vs DYSENTRIC


    WATERY DYSENTRIC
    (enterotoxigenic) (invasive)

    STOOL Watery Bloody


    Apperarance Increased Increased
    Volume Less than 10 Greater than 10
    Number per day Negative Positive
    Occult blood Absent or few many
    Fecal
    polymorphonucle
    ar cells

    MECHANISMS Toxins Mucosal


    Decreased invasion
    absorption

    COMPLICATIO Could be severe Mild


    NS Acidosis, shock, Tenesmus,
    Dehydration elecrolyte rectal prolapse,
    others imbalance seizures

    ETIOLOGY Rotavirus Shigella


    Enterotoxigenic Camphylobacte
    E.coli, Vibrio r
    cholerae Salmonella
    enteritidis

    DEHYDRATION BASED ON PERCENTAGE BODY


    WEIGHT LOSS IN CHILDREN
    MILD (3-5%) MODERATE SEVERE
    (6-9%) (>10%)

    ORT 50 mL/kg ORT 100 mL/kg Ringer lactate 40


    over 2–4 h over 2–4 h mL/kg in 15–30
    min, then 20–40
    Replace ongoing Replace ongoing mL/kg if skin
    losses with low- losses with low- turgor, alertness,
    sodium sodium and pulse have
    ORT (40–60 ORT (40–60 not returned to
    mEq/L Na+) at mEq/L Na+) at normal
    10 mL/kg/stool or 10 mL/kg per
    emesis stool or emesis OR

    Ringer lactate or
    NS 20 mL/kg,
    repeat if
    necessary, and
    then replace
    water and
    electrolyte
    deficits over 1–2
    days Followed by
    ORT 100 mL/kg
    over 4 h.

    Replace ongoing
    losses with low-
    sodium ORT
    (40–60mEq/L
    Na+) at 10 mL/kg
    per stool or
    emesis

    RECOMMENDATIONS FOR ANTI-MICROBIAL


    THERAPY
    PATHOGEN: FIRST-LINE ALTERNATIVE
    Enterotoxigen AGENTS AGENTS
    ic (cholera-
    like) diarrhea

    Vibrio • Doxycycline • Chloramphenicol


    cholerae O1 or 300 mg oral 50 mg/kg IV
    O139 single dose; every 6 hours,
    • tetracycline • erythromycin
    500 mg 250–500
    orally QID× mg orally every 6–8
    3 days; or hours (QID-TDS),
    • Septrin DS and furazolidone
    tablet BD× 3
    days;
    • norfloxacin
    400 mg
    orally BD× 3
    days; or
    • ciprofloxacin
    500 mg
    orally BD× 3
    days or 1 g
    orally single
    dose

    Enterotoxigeni • Norfloxacin Septrin DS tablet BD


    c Escherichia 400 mg or
    Coli ciprofloxacin
    500 mg
    orally BD× 3
    days

    Clostridium Metronidazole • Vancomycin 125


    difficile 250 mg QID to mg orally QID×
    500 mg TDS× 10 10 days;
    days • Bacitracin
    20,000–25,000
    units QID × 7–
    10 days

    PATHOGEN FIRST-LINE ALTERNATIVE


    : Invasive AGENTS AGENTS
    (dysentery-
    like) diarrhea

    Shigella • Septrin DS • Ofloxacin 300


    species BD× 3–5 days mg,
    • norfloxacin
    400 mg, or
    • ciprofloxacin
    500 mg BD× 3
    days, or
    • nalidixic acid
    1 g/day × 5
    days;
    • azithromycin
    500
    mg orally × 1, then
    250 mg orally daily
    × 4 days
    Salmonella • Septrin DS BD; • Azithromycin
    Non typhoidal • ofloxacin 300 1,000 mg
    mg, orally × 1 day,
    • Norfloxacin followed by
    400 mg, or 500 mg orally
    • ciprofloxacin once daily × 6 days
    500 mg BD × 5
    days; or
    • Ceftriaxone 2 g
    IV daily or
    • cefotaxime 2 g
    IV TDS × 5
    days
    •
    Salmonella Ciprofloxacin 500 • Azithromycin
    Enteric fever mg orally BD× 3–14 1,000 mg
    days (ofloxacin orally × 1 day,
    equally efficacious) followed by
    500 mg daily ×
    5days; or
    • cefixime,
    cefotaxime,
    and
    cefuroxime; or
    chloramphenic
    ol
    500 mg QID orally
    or IV × 14 days

    Campylobacte • Erythromycin • Ciprofloxacin


    r 500 mg orally 500 mg or
    BD× 5 days; • norfloxacin
    • azithromycin 400 mg orally
    1,000 mg BD× 5 days
    orally × 1 day,
    followed by 500 mg
    daily× 5 days or
    • clarithromycin
    500 mg orally
    BD

    Yersinia A combination
    species therapy with
    doxycycline,
    aminoglycosides,
    septrin, or
    fluoroquinolones
    PATHOGEN: FIRST-LINE ALTERNATIVE
    Traveler’s AGENTS AGENTS
    diarrhea

    Prophylaxis • Norfloxacin • Rifaximin


    400 mg or 200 mg one
    • ciprofloxacin to TDS × 2
    500 mg orally weeks
    daily
    • Septrin DS
    tablet orally
    daily

    Treatment • Norfloxacin • Rifaximin


    400 mg or 200 mg TDS
    • ciprofloxacin or 400 mg
    500 mg orally BD × 3 days
    BD × 3 days,
    or
    • Septrin DS
    tablet orally
    BD × 3 days
    or
    • azithromycin
    500 mg orally
    OD× 3 days

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