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For further information, see CMDT Part 15-06: Diarrhea

Key Features

Essentials of Diagnosis

  • Diarrhea is acute in onset with a duration of < 2 weeks

  • Severity ranges from mild and self-limited to severe and life-threatening

General Considerations

  • Most commonly caused by infectious agents, bacterial toxins (Table 30–3), or drugs

  • Recent illnesses in family members suggests infectious diarrhea

  • Community outbreaks (schools, nursing homes, cruise ships) suggest viral etiology or common food source

  • Ingestion of improperly stored or prepared food implicates toxin-secreting or invasive bacteria

  • Exposure to unpurified water suggests Giardia or Cryptosporidium

  • Large Cyclospora outbreaks have been traced to contaminated produce

  • Recent travel abroad suggests “traveler's diarrhea”

  • Antibiotic administration suggests Clostridioides difficile colitis

  • HIV infection or sexually transmitted diseases suggest AIDS-associated diarrhea

  • Proctitis and rectal discharge suggest gonorrhea, syphilis, lymphogranuloma venereum, and herpes simplex

Table 30–3.Acute bacterial diarrheas and “food poisoning” (listed in alphabetical order).

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