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<ref name="pmid26584048">{{cite journal |vauthors=Irikura D, Monma C, Suzuki Y, Nakama A, Kai A, Fukui-Miyazaki A, Horiguchi Y, Yoshinari T, Sugita-Konishi Y, Kamata Y |title=Identification and Characterization of a New Enterotoxin Produced by Clostridium perfringens Isolated from Food Poisoning Outbreaks |journal=PLoS ONE |volume=10 |issue=11 |pages=e0138183 |year=2015 |pmid=26584048 |pmc=4652906 |doi=10.1371/journal.pone.0138183 |url=}}</ref> <ref name="pmid12826999">{{cite journal |vauthors=Surawicz CM |title=Antibiotic-associated diarrhea in children: how many dirty diapers? |journal=J. Pediatr. Gastroenterol. Nutr. |volume=37 |issue=1 |pages=2–3 |year=2003 |pmid=12826999 |doi= |url=}}</ref>
<ref name="pmid26584048">{{cite journal |vauthors=Irikura D, Monma C, Suzuki Y, Nakama A, Kai A, Fukui-Miyazaki A, Horiguchi Y, Yoshinari T, Sugita-Konishi Y, Kamata Y |title=Identification and Characterization of a New Enterotoxin Produced by Clostridium perfringens Isolated from Food Poisoning Outbreaks |journal=PLoS ONE |volume=10 |issue=11 |pages=e0138183 |year=2015 |pmid=26584048 |pmc=4652906 |doi=10.1371/journal.pone.0138183 |url=}}</ref> <ref name="pmid12826999">{{cite journal |vauthors=Surawicz CM |title=Antibiotic-associated diarrhea in children: how many dirty diapers? |journal=J. Pediatr. Gastroenterol. Nutr. |volume=37 |issue=1 |pages=2–3 |year=2003 |pmid=12826999 |doi= |url=}}</ref>


{| class="wikitable"
Bacterial:
!Population
*Shigella species ( S.dysentriae,  S.flexneri, S.sonneii, S.boydii)       
!Life threatening causes
*E.coli species ( Enterotoxigenic E.coli, Enterohemorrhagic E.coli, Enteroinvasive E.coli)
!Common causes
*Vibrio cholerae
!Less common causes
*Non Typhoidal Salmonella: S.typhimurium, S.enterica
|-
*[[Campylobacter jejuni]]
|'''Children'''
*Clostridium difficle: Antibiotic associated diarrhea (eg: Amoxicillin with clavulanic acid, Clindamycin, Cephalosporins)
|Certain medical conditions causing diarrhea in children may be life threatening.
*Yersinia enterocolitica
* Sepsis:
*Aeromonas
*Sepsis:
**Staphylococcus aureus'' (staphylococcal toxic shock syndrome [TSS])''
**Staphylococcus aureus'' (staphylococcal toxic shock syndrome [TSS])''
**Salmonella septicemia
**Salmonella septicemia
*Hemolytic uraemic syndrome (Shiga toxin producing E. coli ETEC)
*Hemolytic uraemic syndrome (Shiga toxin producing E. coli ETEC)
*Intususseption
*Shigella species
*Congenital secretory diarrheas
*Non typhoidal Salmonella
|'''Infectious''':
*Clostridium difficile
*'''Viral:'''
*Campylobacter jejuni
**Rota virus
* Escherichia coli :
**Noro virus
**ETEC
*'''Bacterial:'''
**EPEC
**Shigella species ( S.dysentriae,  S.flexneri, S.sonneii, S.boydii)       
**EHEC
**E.coli species ( Enterotoxigenic E.coli, Enterohemorrhagic E.coli, Enteroinvasive E.coli)
**EIEC
**Vibrio cholerae
**EAEC
**Non Typhoidal Salmonella: S.typhimurium, S.enterica
*Yersinia enterocolitica
**[[Campylobacter jejuni]]
*Vibrio cholera
**Clostridium difficle: Antibiotic associated diarrhea (eg: Amoxicillin with clavulanic acid, Clindamycin, Cephalosporins)
*Vibrio parahemolyticus
**Yersinia enterocolitica
*Aeromonas
*'''Protozoa''': Entamoeba histolytica,Cryptosporidium parvum
*Plesiomonas shigelloides
'''Functional diarrhea'''
*Mycobacterium Avium complex
|
*Staphylococcal aureus
*Bacillus cereus
*Clostridium perfringens
*''Listeria monocytogenes'' (in immuno compromised)
 
'''Viral:'''
*Rota virus
*Noro virus
*Adeno virus
*Adeno virus
*Astro virus
*Astro virus
*Calcivirus
*Calcivirus
*Aeromonas
*Influenza, measles, dengue fever, human immunodeficiency virus
*'''Systemic conditions associated with diarrhea''':
*Noro virus
Influenza, measles, dengue fever, human immunodeficiency virus. Systemic infections associated with diarrhea include pneumonia,Otitis media, sepsis,urinary tract infection.
*Rota virus
* Enteric Adeno virus
*HIV Infection
*CMV
*Astro virus
*Norwalk virus
'''Protozoa''':
 
Entamoeba histolytica
 
Cryptosporidium parvum
*Entamoeba histolytica
*Giardia lamblia
*Microsporidia
*Isospora
 
Systemic infections
 
sepsis,urinary tract infection
 
appendicitis, Intussusception
 
'''Short bowel syndrome'''
 
'''Radiation or chemotherapy enteritis'''


'''Intra abdominal emergencies''' including appendicitis, Intussusception
'''Hyperthyroidism'''
|-
|'''Adults'''
|There are no life-threatening causes of Acute diarrhea; however, complications resulting from untreated Acute diarrhea are common.
|
'''Infections''':
*'''Bacterial:'''
**Shigella species
**Non typhoidal Salmonella
**Clostridium difficile
**Campylobacter jejuni
** Escherichia coli :
***ETEC
***EPEC
***EHEC
***EIEC
***EAEC
**Yersinia enterocolitica
**Vibrio cholera
**Vibrio parahemolyticus
**Aeromonas
**Plesiomonas shigelloides
**Mycobacterium Avium complex


*'''Food poisoning:'''  
'''Irritable bowel syndrome'''
**Staphylococcal aureus
**Bacillus cereus
**Clostridium perfringens


*'''Viral''':
'''Tropical sprue (initial stages)'''
**Noro virus
**Rota virus
** Enteric Adeno virus
**HIV Infection
**CMV
**Astro virus
**Norwalk virus


*'''Protozoan and Parasitic:'''
'''Ischemic colitis(initial stages)'''
**Entamoeba histolytica
**Giardia lamblia
**Microsporidia
**Isospora


'''Non infectious''':
'''Tumors''': VIPoma
 
'''Disorders of digestive/absorptive processes''':
*Glucose-galactose malabsorption
*Sucrase-isomaltase deficiency
*Late-onset (adult-type) hypolactasia, leads to lactose intolerance
'''Intra abdominal emergencies''' including appendicitis,Infectious colitis.


'''Medicatons''':
'''Medicatons''':
Line 107: Line 109:
*Chemotherapeutic agents
*Chemotherapeutic agents
*Antifungals
*Antifungals
*ACE inhibitors
*Digoxin
*Digoxin
*Statins
*Thiazide diuretics
*Thiazide diuretics
*Lactulose
*Lactulose
'''Ingestion of plants''' (eg, hyacinths, daffodils, Amanita species mushrooms)
'''Ingestion of plants''' (eg, hyacinths, daffodils, Amanita species mushrooms)


Line 123: Line 122:
'''Opium withdrawal'''
'''Opium withdrawal'''


'''Short bowel syndrome'''(initial stages)
{| class="wikitable"
!Population
!Life threatening causes
!Common causes
!Less common causes
|-
|'''Children'''
|
*
|
**
**
*
'''Functional diarrhea'''
|
*'''Systemic conditions associated with diarrhea''':
. .


'''Radiation or chemotherapy enteritis'''(initial stages)
'''Intra abdominal'''  
|''Listeria monocytogenes'' (in immuno compromised)
*
*
*
'''emergencies''' including
|-
|'''Adults'''
|
|
<nowiki>:</nowiki>
**


'''Hyperthyroidism'''
'''Non infectious''':
 
*
'''Irritable bowel syndrome'''
 
'''Tropical sprue (initial stages)'''
 
'''Ischemic colitis(initial stages)'''
 
'''Tumors''': VIPoma
 
'''Disorders of digestive/absorptive processes''':
*Glucose-galactose malabsorption
*Sucrase-isomaltase deficiency
*Late-onset (adult-type) hypolactasia, leads to lactose intolerance
'''Intra abdominal emergencies''' including appendicitis,Infectious colitis.


|
|-
|-
|
|

Revision as of 13:41, 8 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

Overview

  • The causes of acute diarrhoea are based on geographical location, food hygiene standards, sanitation, water supply, and season.
  • Common causes of acute diarrhea in children in both developing and developed nations are infections. Infectious gastroenterits is most commonly caused by Rota virus, Shigella, Enterotoxigenic E.coli ETEC , Campylobacter, Cryptosporidium parvum. Less commonly, acute diarrhea in children can be caused by Norwalk like viruses, can be associated with systemic infections including Influenza, UTI, Otitis media, HIV infection.

Causes

Causes: [1] [2] [3] [4] [5] [6] [7] [8] [9] [10]

Bacterial:

  • Shigella species ( S.dysentriae, S.flexneri, S.sonneii, S.boydii)
  • E.coli species ( Enterotoxigenic E.coli, Enterohemorrhagic E.coli, Enteroinvasive E.coli)
  • Vibrio cholerae
  • Non Typhoidal Salmonella: S.typhimurium, S.enterica
  • Campylobacter jejuni
  • Clostridium difficle: Antibiotic associated diarrhea (eg: Amoxicillin with clavulanic acid, Clindamycin, Cephalosporins)
  • Yersinia enterocolitica
  • Aeromonas
  • Sepsis:
    • Staphylococcus aureus (staphylococcal toxic shock syndrome [TSS])
    • Salmonella septicemia
  • Hemolytic uraemic syndrome (Shiga toxin producing E. coli ETEC)
  • Shigella species
  • Non typhoidal Salmonella
  • Clostridium difficile
  • Campylobacter jejuni
  • Escherichia coli :
    • ETEC
    • EPEC
    • EHEC
    • EIEC
    • EAEC
  • Yersinia enterocolitica
  • Vibrio cholera
  • Vibrio parahemolyticus
  • Aeromonas
  • Plesiomonas shigelloides
  • Mycobacterium Avium complex
  • Staphylococcal aureus
  • Bacillus cereus
  • Clostridium perfringens
  • Listeria monocytogenes (in immuno compromised)

Viral:

  • Rota virus
  • Noro virus
  • Adeno virus
  • Astro virus
  • Calcivirus
  • Influenza, measles, dengue fever, human immunodeficiency virus
  • Noro virus
  • Rota virus
  • Enteric Adeno virus
  • HIV Infection
  • CMV
  • Astro virus
  • Norwalk virus

Protozoa:

Entamoeba histolytica

Cryptosporidium parvum

  • Entamoeba histolytica
  • Giardia lamblia
  • Microsporidia
  • Isospora

Systemic infections

sepsis,urinary tract infection

appendicitis, Intussusception

Short bowel syndrome

Radiation or chemotherapy enteritis

Hyperthyroidism

Irritable bowel syndrome

Tropical sprue (initial stages)

Ischemic colitis(initial stages)

Tumors: VIPoma

Disorders of digestive/absorptive processes:

  • Glucose-galactose malabsorption
  • Sucrase-isomaltase deficiency
  • Late-onset (adult-type) hypolactasia, leads to lactose intolerance

Intra abdominal emergencies including appendicitis,Infectious colitis.

Medicatons:

  • Antibiotics, mostly with Cephalosporins
  • Magnesium containing antacids
  • Laxatives
  • Anti retroviral agents
  • Chemotherapeutic agents
  • Antifungals
  • Digoxin
  • Thiazide diuretics
  • Lactulose

Ingestion of plants (eg, hyacinths, daffodils, Amanita species mushrooms)

Food allergies:

  • Cow's milk protein allergy
  • Soy protein allergy

Organophosphate poisoning

Opium withdrawal

Population Life threatening causes Common causes Less common causes
Children

Functional diarrhea

  • Systemic conditions associated with diarrhea:

. .

Intra abdominal

emergencies including

Adults

:

Non infectious:

References:

  1. ↑ Mokomane M, Kasvosve I, de Melo E, Pernica JM, Goldfarb DM (2018). "The global problem of childhood diarrhoeal diseases: emerging strategies in prevention and management". Ther Adv Infect Dis. 5 (1): 29–43. doi:10.1177/2049936117744429. PMC 5761924. PMID 29344358.
  2. ↑ de Bruyn G (2008). "Diarrhoea in adults (acute)". BMJ Clin Evid. 2008. PMC 2907942. PMID 19450323.
  3. ↑ Chiejina M, Samant H. PMID 29262044. Missing or empty |title= (help)
  4. ↑ Dalby-Payne JR, Elliott EJ (2009). "Gastroenteritis in children". BMJ Clin Evid. 2009. PMC 2907797. PMID 21726481.
  5. ↑ Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, Wu Y, Sow SO, Sur D, Breiman RF, Faruque AS, Zaidi AK, Saha D, Alonso PL, Tamboura B, Sanogo D, Onwuchekwa U, Manna B, Ramamurthy T, Kanungo S, Ochieng JB, Omore R, Oundo JO, Hossain A, Das SK, Ahmed S, Qureshi S, Quadri F, Adegbola RA, Antonio M, Hossain MJ, Akinsola A, Mandomando I, Nhampossa T, Acácio S, Biswas K, O'Reilly CE, Mintz ED, Berkeley LY, Muhsen K, Sommerfelt H, Robins-Browne RM, Levine MM (2013). "Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study". Lancet. 382 (9888): 209–22. doi:10.1016/S0140-6736(13)60844-2. PMID 23680352.
  6. ↑ Chhabra P, Payne DC, Szilagyi PG, Edwards KM, Staat MA, Shirley SH, Wikswo M, Nix WA, Lu X, Parashar UD, Vinjé J (2013). "Etiology of viral gastroenteritis in children <5 years of age in the United States, 2008-2009". J. Infect. Dis. 208 (5): 790–800. doi:10.1093/infdis/jit254. PMID 23757337.
  7. ↑ Pang XL, Honma S, Nakata S, Vesikari T (2000). "Human caliciviruses in acute gastroenteritis of young children in the community". J. Infect. Dis. 181 Suppl 2: S288–94. doi:10.1086/315590. PMID 10804140.
  8. ↑ Cohen MB (1991). "Etiology and mechanisms of acute infectious diarrhea in infants in the United States". J. Pediatr. 118 (4 Pt 2): S34–9. PMID 2007955.
  9. ↑ Irikura D, Monma C, Suzuki Y, Nakama A, Kai A, Fukui-Miyazaki A, Horiguchi Y, Yoshinari T, Sugita-Konishi Y, Kamata Y (2015). "Identification and Characterization of a New Enterotoxin Produced by Clostridium perfringens Isolated from Food Poisoning Outbreaks". PLoS ONE. 10 (11): e0138183. doi:10.1371/journal.pone.0138183. PMC 4652906. PMID 26584048.
  10. ↑ Surawicz CM (2003). "Antibiotic-associated diarrhea in children: how many dirty diapers?". J. Pediatr. Gastroenterol. Nutr. 37 (1): 2–3. PMID 12826999.
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