Clinical Management of Infectious Diarrhea

Abstract

Background: Infectious diarrhea is the most common cause of diarrhea worldwide and is responsible for more deaths than other gastrointestinal tract diseases such as gastrointestinal cancers, peptic ulcer disease or inflammatory bowel disease. Diarrheal disease still represents the 8th leading cause of death worldwide, with more than 1,6 million attributed fatalities in 2016 alone. The majority of cases can be divided into three principal clinical presentations: acute watery diarrhea lasting 5-10 days and normally self-limiting, bloody diarrhea (dysentery), and persistent diarrhea with or without intestinal malabsorption. Methods: We performed an electronic search on PUBMED of the scientific literature concerning infectious diarrhea and its clinical management. Aim: In this review article, we analyze the most important causes of infectious diarrhea and their constellation of signs and symptoms, providing an update on the diagnostic tools available in today’s practice and on the different treatment options. Conclusions: Even though the majority of intestinal infections are self-limiting in immunocompetent individuals, specific diagnosis and identification of the causative agent remain crucial from a public health and epidemiological perspective. Specific diagnostic investigation can be reserved for patients with severe dehydration, more severe illness, persistent fever, bloody stools or immunosuppression, and for cases of suspected nosocomial infection or outbreak and it includes complete blood count, creatinine and electrolytes, determination of leukocytes and lactoferrin precence in the stools, stool culture, together with C. difficile testing, PCR, ova and parasites' search, endoscopy and abdominal imaging. Since acute diarrhea is most often self-limited and caused by viruses, routine antibiotic use is not recommended for most adults with mild, watery diarrhea. However, when used appropriately, antibiotics are effective against shigellosis, campylobacteriosis, C. difficile colitis, traveler’s diarrhea, and protozoal infections. Furthermore, antibiotics use should be considered in patients who are older than 65 years, immunocompromised, severely ill, or septic.

Intestinal Parasitic Infections Among Pediatric Patients in a Metropolitan City of Bangladesh With Emphasis on Cryptosporidiosis

“…Diarrhea is the passage of three or more liquid or loose stools per day or if the individual experiences more frequent passage than usual [1][2][3]. It is categorized clinically as i) acute watery diarrhea, which persists for several hours or days [4], ii) persistent diarrhea that lasts for 14 days or longer [5], and finally, iii) dysentery, blood, and mucous found in diarrheal stool [6,7]. Previously, diarrhea was one of the deadliest diseases [8,9] and remains the second dominant cause of child mortality worldwide [10,11].…”

A review of Brucea javanica: metabolites, pharmacology and clinical application

“…In modern medicine, "dysentery" encompasses ulcerative colitis and bacillary dysentery (Yu et al, 2023). The primary causes of dysentery are bacterial and amoebic infections (Siciliano et al, 2021), which primarily result in gastroenteritis and ulcerative gastroenteritis. The potential efficacy of BJ in treating dysentery may stem from its antibacterial and antiinflammatory characteristics.…”

Clinical characteristics and influencing factors of infectious diarrhea in preschool children: An observational study

“…In some severe patients, deteriorated electrolyte disorder, severe dehydration, and other serious complications can result in death, which is hazardous to children's health. [1,2] Previous study has reported that diarrhea is one of the top ten leading causes of death worldwide, which was responsible for 500,000 deaths per year in children. [3] Over the past decades, the morbidity of infectious diarrhea remained at a high level in China, accounting for nearly 20% of notifiable infectious diseases.…”