Chapter 040. Diarrhea and Constipation (Part 5)
Mô tả tài liệu
Table 40-2 Association between Pathobiology of Causative Agents and Clinical Features in Acute Infectious Diarrhea Pathobiolo gy/Agents bation Incu miting Vo Abd ominal Pain ever F rrhea Dia Period Toxin producers Preforme d toxin Bacillus cereus, Staphylococcus aureus, h 1–8 4+ 3– 1–2+ –1+ 0 4+, watery 3– Clostridi um perfringens h 8–24 Enterotox in Vibrio cholerae, enterotoxigenic Escherichia coli, Klebsiella pneumoniae, Aeromonas h 8–72 4+ 2– 1–2+ –1+ 0 4+, watery 3– species Enteroadhe rent Enteropat hogenic and d 1–8 1+ 0– 1–3+ –2+ 0 2+, 1– enteroadherent E. coli, Giardia watery, mushy organisms, cryptosporidiosis, helminths Cytotoxinproducers Clostridiu m difficile d 1–3 1+ 0– 3–4+ –2+ 1 3+, 1– usually watery, occasional ly bloody ...
Tóm tắt nội dung
Chapter 040. Diarrhea and
Constipation
(Part 5)
Table 40-2 Association between Pathobiology of Causative Agents and
Clinical Features in Acute Infectious Diarrhea
Pathobiolo
gy/Agents
Incu
bation
Period
Vo
miting
Abd
ominal
Pain
F
ever
Dia
rrhea
Toxin
producers
Preforme
d toxin
Bacillus
cereus,
Staphylococcus
aureus,
1–8
h
3–
4+
1–2+ 0
–1+
3–
4+,
watery
Clostridi
um perfringens
8–24
h
Enterotox
in
Vibrio
cholerae,
enterotoxigenic
Escherichia coli,
Klebsiella
pneumoniae,
Aeromonas
8–72
h
2–
4+
1–2+ 0
–1+
3–
4+,
watery
species
Enteroadhe
rent
Enteropat
hogenic and
enteroadherent E.
coli, Giardia
organisms,
cryptosporidiosis,
helminths
1–8
d
0–
1+
1–3+ 0
–2+
1–
2+,
watery,
mushy
Cytotoxin-
producers
Clostridiu
m difficile
1–3
d
0–
1+
3–4+ 1
–2+
1–
3+,
usually
watery,
occasional
ly bloody
Hemorrha
gic E. coli
12–
72 h
0–
1+
3–4+ 1
–2+
1–
3+,
initially
watery,
quickly
bloody
Invasive
organisms
Minimal
inflammation
Rotaviru
s and Norwalk
agent
1–3
d
1–
3+
2–3+ 3
–4+
1–
3+,
watery
Variable
inflammation
Salmone
lla,
Campylobacter,
and Aeromonas
species, Vibrio
parahaemolyticus,
Yersinia
12
h–11 d
0–
3+
2–4+ 3
–4+
1–
4+,
watery or
bloody
Severe
inflammation
Shigella
species,
enteroinvasive E.
coli, Entamoeba
histolytica
12
h–8 d
0–
1+
3–4+ 3
–4+
1–
2+,
bloody
Source: Adapted from DW Powell, in T Yamada (ed): Textbook of
Gastroenterology and Hepatology, 4th ed. Philadelphia, Lippincott Williams &
Wilkins, 2003; and DR Syndman, in SL Gorbach (ed): Infectious Diarrhea.
London, Blackwell, 1986.
Finally, infectious diarrhea may be associated with systemic
manifestations. Reiter's syndrome (arthritis, urethritis, and conjunctivitis) may
accompany or follow infections by Salmonella, Campylobacter, Shigella, and
Yersinia. Yersiniosis may also lead to an autoimmune-type thyroiditis,
pericarditis, and glomerulonephritis. Both enterohemorrhagic E. coli (O157:H7)
and Shigella can lead to the hemolytic-uremic syndrome with an attendant high
mortality rate. The syndrome of postinfectious IBS has now been recognized as a
complication of infectious diarrhea. Acute diarrhea can also be a major symptom
of several systemic infections including viral hepatitis, listeriosis, legionellosis,
and toxic shock syndrome.