Acute gastroenteritis: Difference between revisions
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*Reptiles | *Reptiles | ||
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| Shigella||1-3 days|| | | Shigella||1-3 days|| | ||
*Fever | |||
*abd pain | |||
*headache | |||
*1-5 years old | |||
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*Food | |||
*Fecal-Oral | |||
|- | |- | ||
| Yersinia||1-5 days|| | | Yersinia||1-5 days|| | ||
*Appy Mimic, RLQ Pain | |||
*Fever | |||
*Vomiting | |||
*Kids and Young Adults | |||
|| | |||
*Water | |||
*Milk | |||
*Pork | |||
*Wild Animals | |||
*Fecal-Oral | |||
|- | |- | ||
| Campylobacter||1-7 days|| | | Campylobacter||1-7 days|| | ||
*Low grade fever | |||
*Abd pain | |||
*Kids and Young Adults | |||
|| | |||
*Water | |||
*Poultry | |||
*Pets/Animals | |||
|- | |- | ||
| C. Dif||10 days|| | | C. Dif||10 days|| | ||
*Copious FOUL diarrhea | |||
|| | |||
*ABX use: PCN, Clinda, Cephalos | |||
|- | |- | ||
| Entamoeba||1-11 weeks|| | | Entamoeba||1-11 weeks|| | ||
*Appy Mimic | |||
*Abd, n/v/d | |||
|| | |||
*Water | |||
*Sanitation | |||
*Travel | |||
|} | |} | ||
Revision as of 20:20, 25 January 2015
Background
- Blood diarrhea suggests bacterial etiology
- Viral AGE usually lasts <7d
- Do not dx isolated vomiting as AGE
Diagnosis
- Vomiting/diarrhea
- Crampy/diffuse abdominal pain
Work-Up
- Assess hydration status
- Cap refill, skin turgor, resp rate
- Consider stool labs if:
- >10 stools in previous 24hr
- Travel to high-risk country
- Fever
- Bloody stool
- Persistent diarrhea
DDx
| Species | Onset | Symptoms | Transmission |
|---|---|---|---|
| Salmonella | 6-72 hours |
|
|
| Shigella | 1-3 days |
|
|
| Yersinia | 1-5 days |
|
|
| Campylobacter | 1-7 days |
|
|
| C. Dif | 10 days |
|
|
| Entamoeba | 1-11 weeks |
|
|
Treatment
- Oral rehydration therapy
- 30mL(1oz)/kg/hr
- Antiemetic
- Ondansetron 0.15mg/kg/dose IV/PO
- Antibiotics
- Only consider in pts w/ invasive infection
- Shigella, campylobacter, E. coli, yersinia, vibrio
- Bloody stool w/ mucus and fever
- NOT indicated for E. coli O157:H7
- NOT routinely indicated for salmonella
- Exceptions: SCD, IBD, <3mo
- Azithromycin (able to tolerate PO)
- Ceftriaxone (parenteral)
- Only consider in pts w/ invasive infection
Disposition
See Also
Source
Tintinalli
