diarrhea%20in%20adults%20-%20infectious
DIARRHEA IN ADULTS - INFECTIOUS
Diarrhea is a change in normal bowel movements characterized by increased frequency, water content or volume of stools.
Infectious diarrhea is diarrhea of infectious origin (bacteria, virus, protozoal) and is usually associated with symptoms of nausea and vomiting and abdominal cramps.
Dysentery (invasive diarrhea) has the presence of visible blood in diarrheic stool.

Definition

  • Diarrhea: Change in normal bowel movements characterized by increase in frequency, water content or volume of stools
    • ≥3 episodes/day or at least 250 g/stool per day
  •  Acute diarrhea: Diarrhea lasting <14 days duration
  • Persistent diarrhea: Diarrhea lasting ≥14 days
  • Chronic diarrhea: Diarrhea lasting ≥30 days
  • Infectious diarrhea: Diarrhea of infectious origin (bacterial, viral, protozoal) and is usually associated with symptoms of nausea and vomiting (N/V) and abdominal cramps
  • Dysentery (Invasive diarrhea): Presence of visible blood in diarrheic stool

Signs and Symptoms

  • Determine abrupt or gradual onset, duration and progression of symptoms
  • Onset and frequency of bowel movement
  • Amount of stool excreted
  • If dysenteric symptoms are present (eg fever, tenesmus, blood/pus in stool)

Associated Symptoms

  • Frequency and intensity of N/V, abdominal pain, cramps, myalgia, headache, altered sensorium

Stool Characteristics

  • Watery, bloody, mucus, purulent, greasy

Symptoms of Volume Depletion

  • Thirst
  • Tachycardia
  • Orthostasis
  • Decreased urination
  • Decrease in skin turgor
  • Lethargy

Risk Factors

Epidemiological Risk Factors

  • Place of residence
  • Travel to developing country
  • Daycare attendance, employment
  • Ingestion of unsafe foods (eg raw meats, eggs, shellfish, etc)
  • Swimming/drinking untreated fresh water
  • Visit to farm or contact with pets with diarrhea
  • Contact with other ill persons
  • Recent or regular medications (eg antibiotics, antacids, antimotility agents)
  • Underlying medical conditions [acute immunodeficiency syndrome (AIDS), immunosuppressants, elderly]
  • Receptive anal or oral-anal sexual contact
  • Occupation as food-handler or caregiver
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
07 Jun 2018
Recurrent acute uncomplicated urinary tract infection (UTI) negatively affects quality of life (QOL), including physical and mental health status, in premenopausal women, according to a study. QOL may even be lower in UTI-infected women with comorbid chronic constipation or who consume caffeine.
Pank Jit Sin, 12 Jun 2018
The common antimicrobial agent, triclosan, has been implicated in colonic inflammation and the disease development of colitis and colitis-associated colon cancer, reveals a study appearing in Science Translational Medicine. [doi:10.1126/scitranslmed.aan4116] 
Roshini Claire Anthony, 30 May 2018

The use of procalcitonin assays had little impact on antibiotic exposure in patients who presented to emergency departments (ED) with suspected lower respiratory tract infections, according to findings of the ProACT* trial presented at the recent sessions of the American Thoracic Society (ATS 2018).