Gastroenteritis: Difference between revisions
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==Overview== | ==Overview== | ||
Acute gastroenteritis and diarrhea are among the leading causes of seeking medical care. Approximately, 48 million cases occur annually that cost about $150 million for the U.S. health care system. <ref name="pmid21192849">{{cite journal |vauthors=Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM |title=Foodborne illness acquired in the United States--unspecified agents |journal=Emerging Infect. Dis. |volume=17 |issue=1 |pages=16–22 |year=2011 |pmid=21192849 |pmc=3204615 |doi=10.3201/eid1701.091101p2 |url=}}</ref><ref name="pmid21192848">{{cite journal |vauthors=Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM |title=Foodborne illness acquired in the United States--major pathogens |journal=Emerging Infect. Dis. |volume=17 |issue=1 |pages=7–15 |year=2011 |pmid=21192848 |pmc=3375761 |doi=10.3201/eid1701.091101p1 |url=}}</ref> Gastroenteritis is defined as [[inflammation]] of the [[stomach]] or [[intestinal mucosa]]. It typically presents with acute [[diarrhea]], [[fever]], [[nausea]] and [[vomiting]], [[anorexia]] and crampy [[abdominal pain]] and is defined as passage of loose stool for at least 3 times per day for less than 14 days. It may be caused by [[viruses]], [[bacteria]] or parasites. Most cases of acute gastroenteritis are caused by viruses and among them, [[ | Acute gastroenteritis and diarrhea are among the leading causes of seeking medical care. Approximately, 48 million cases occur annually that cost about $150 million for the U.S. health care system. <ref name="pmid21192849">{{cite journal |vauthors=Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM |title=Foodborne illness acquired in the United States--unspecified agents |journal=Emerging Infect. Dis. |volume=17 |issue=1 |pages=16–22 |year=2011 |pmid=21192849 |pmc=3204615 |doi=10.3201/eid1701.091101p2 |url=}}</ref><ref name="pmid21192848">{{cite journal |vauthors=Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM |title=Foodborne illness acquired in the United States--major pathogens |journal=Emerging Infect. Dis. |volume=17 |issue=1 |pages=7–15 |year=2011 |pmid=21192848 |pmc=3375761 |doi=10.3201/eid1701.091101p1 |url=}}</ref> Gastroenteritis is defined as [[inflammation]] of the [[stomach]] or [[intestinal mucosa]]. It typically presents with acute [[diarrhea]], [[fever]], [[nausea]] and [[vomiting]], [[anorexia]] and crampy [[abdominal pain]] and is defined as passage of loose stool for at least 3 times per day for less than 14 days. It may be caused by [[viruses]], [[bacteria]] or [[parasites]]. Most cases of acute gastroenteritis are caused by viruses and among them, [[norovirus]] ([[norwalk virus]]) is the most common etiology for adults.<ref name="pmid22454468">{{cite journal |vauthors=Bresee JS, Marcus R, Venezia RA, Keene WE, Morse D, Thanassi M, Brunett P, Bulens S, Beard RS, Dauphin LA, Slutsker L, Bopp C, Eberhard M, Hall A, Vinje J, Monroe SS, Glass RI |title=The etiology of severe acute gastroenteritis among adults visiting emergency departments in the United States |journal=J. Infect. Dis. |volume=205 |issue=9 |pages=1374–81 |year=2012 |pmid=22454468 |doi=10.1093/infdis/jis206 |url=}}</ref><ref name="pmid21801613">{{cite journal |vauthors=Hall AJ, Rosenthal M, Gregoricus N, Greene SA, Ferguson J, Henao OL, Vinjé J, Lopman BA, Parashar UD, Widdowson MA |title=Incidence of acute gastroenteritis and role of norovirus, Georgia, USA, 2004-2005 |journal=Emerging Infect. Dis. |volume=17 |issue=8 |pages=1381–8 |year=2011 |pmid=21801613 |pmc=3381564 |doi=10.3201/eid1708.101533 |url=}}</ref><ref name="pmid23235338">{{cite journal |vauthors=Wikswo ME, Hall AJ |title=Outbreaks of acute gastroenteritis transmitted by person-to-person contact--United States, 2009-2010 |journal=MMWR Surveill Summ |volume=61 |issue=9 |pages=1–12 |year=2012 |pmid=23235338 |doi= |url=}}</ref> Other common viral causes include, [[Rotavirus]], [[Adenovirus]] and [[Astrovirus]]. Common bacterial causes of gastroenteritis include, [[Escherichia coli|Escherichia coli sp]], [[Salmonella|Salmonella sp]], [[Yersinia enterocolitica]] and [[Vibrio|Vibrio sp]] that can cause watery diarrhea and [[Shigella|Shigella sp]] and [[Campylobacter|Campylobacter sp]] that can cause [[Dysentery|dysenteric diarrhea]]. Parasites are other causes of gastroenteritis especially in developing countries which [[Giardia lamblia]] and [[Entamoeba histolytica]] are the most frequent causes. First step in management of this patients is to evaluate the [[Volume status|hydration status]] and [[vital signs]]. Once the patient is stabilized, health care provider must proceed to diagnostic evaluation. There are some principles to decrease the risk of acquiring infection which include, using safe water and foods, avoid unsafe foods during traveling and hand washing. | ||
==Classification== | ==Classification== | ||
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<br> | <br> | ||
{{familytree/start}} | {{familytree/start}}{{familytree || | | | | | | | | | | | | | | | | | | | | | A01 |A01='''Gastroenteritis'''}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | A01 |A01='''Gastroenteritis'''}} | |||
{{familytree | | | | |,|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|.| | | }} | {{familytree | | | | |,|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|.| | | }} | ||
{{familytree | | | | B01 | | | | | | | | | | | | | | | | | B02 | | | | | | | | | | | | | | | B03 |B01='''Viral'''|B02='''Bacterial'''|B03='''Parasites'''}} | {{familytree | | | | B01 | | | | | | | | | | | | | | | | | B02 | | | | | | | | | | | | | | | B03 |B01='''Viral'''|B02='''Bacterial'''|B03='''Parasites'''}} | ||
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{{familytree | | C01 | | C02 | | | | | | | | C03 | | | | | | | | | | | | | C04 | | | | | C05 | | C06 |C01=Common|C02=Less Common|C03=Common|C04=Less Common|C05=Helminthic|C06=Protozoal}} | {{familytree | | C01 | | C02 | | | | | | | | C03 | | | | | | | | | | | | | C04 | | | | | C05 | | C06 |C01=Common|C02=Less Common|C03=Common|C04=Less Common|C05=Helminthic|C06=Protozoal}} | ||
{{familytree | | |!| | | |!| | | | | |,|-|-|-|^|-|-|-|.| | | | | | | |,|-|-|^|-|-|.| | | |!| | | |!|}} | {{familytree | | |!| | | |!| | | | | |,|-|-|-|^|-|-|-|.| | | | | | | |,|-|-|^|-|-|.| | | |!| | | |!|}} | ||
{{familytree |boxstyle=text-align: left; | | D01 | | D02 | | | | D03 | | | | | | D04 | | | | | | D05 | | | | D06 | | D07 | | D08 |D01= •[[Rotavirus infection|Rotavirus]]<br>•[[Norovirus infection|Norovirus]]<br> | {{familytree |boxstyle=text-align: left; | | D01 | | D02 | | | | D03 | | | | | | D04 | | | | | | D05 | | | | D06 | | D07 | | D08 |D01= •[[Rotavirus infection|Rotavirus]]<br>•[[Norovirus infection|Norovirus]]<br>• [[Adenovirus]]<br>•[[Astroviruses]] |D02= •[[Enterovirus]] <br>•[[Coronavirus]] <br>(including SARS) <br>•[[Parvovirus]] •Kobuviruses <br>•[[Orthoreovirus]] •Torovirus <br> |D03=Gram Positive|D04=Gram Negative|D05=Gram Positive|D06=Gram Negative | D07= •[[Trichinella spiralis]]<br>•[[Whipworm infection|Trichuris trichiura]]<br>•[[Strongyloidiasis|Strongyloides stercoralis]]<br>•[[Taenia solium]]<br>•[[Taenia saginata]] <br>•[[Diphyllobothrium|Diphyllobothrium latum]]<br>•[[Schistosomiasis|Schistosoma mansoni]]|D08= •[[Giardiasis|Giardia lamblia]] <br>•[[Amoebiasis|Entamoeba histolytica]]‡<br>•[[Cryptosporidiosis|Cryptosporidium parvum]] <br>•[[Cyclosporiasis|Cyclospora cayetanensis]] }} | ||
{{familytree | | | | | | | | | | | | |!| | | | |,|-|-|^|-|-|.| | | | |!| | | | | |!| | | | |}} | {{familytree | | | | | | | | | | | | |!| | | | |,|-|-|^|-|-|.| | | | |!| | | | | |!| | | | |}} | ||
{{familytree |boxstyle=text-align: left; | | | | | | | | | | | | E01 | | | E02 | | | | E03 | | | E04 | | | | E05 | |E01= •[[Clostridium perfringens]]<br>•[[Clostridium difficile infection|Clostridium difficile]] | E02= | {{familytree |boxstyle=text-align: left; | | | | | | | | | | | | E01 | | | E02 | | | | E03 | | | E04 | | | | E05 | |E01= •[[Clostridium perfringens]]<br>•[[Clostridium difficile infection|Clostridium difficile]] | E02=Bloody diarrhea (dysentery) | E03= Watery diarrhea |E04=• [[Bacillus cereus]] <br> | ||
• [[Listeriosis|Listeria monocytogenes]] <br> | |||
• [[Mycobacterium sp*.]] <br> | |||
• [[Clostridium botulinum]] <br> | E05= •[[Bacteroides fragilis]] <br>•[[Aeromonas hydrophila]]}} | |||
{{familytree | | | | | | | | | | | | | | | | | |!| | | | | |!| | }} | {{familytree | | | | | | | | | | | | | | | | | |!| | | | | |!| | }} | ||
{{familytree |boxstyle=text-align: left; | | | | | | | | | | | | | | | | | F01 | | | | F02 | | F01=•[[Shigellosis|Shigella ''sp.'']], •[[ | {{familytree |boxstyle=text-align: left; | | | | | | | | | | | | | | | | | F01 | | | | F02 | | F01=•[[Campylobacter|Campylobacter ''sp.'']] | ||
•[[Shigellosis|Shigella ''sp.'']] | |||
•[[Escherichia coli enteritis|Escherichia coli]] | |||
(EHEC, EIEC) | |||
•[[Salmonellosis|Salmonella(non-typhoidal) ''sp.''†]]<br>|F02= •[[Escherichia coli enteritis|Escherichia coli]] <br>(ETEC, EPEC, EAEC)<br> | |||
•[[Salmonellosis|Salmonella(typhoidal) ''sp.''†]]<br> | |||
•[[Yersinia enterocolitica infection|Yersinia enterocolitica]]†<br> | |||
•[[Cholera|Vibrio ''sp.'']] }} | |||
{{familytree/end}} | {{familytree/end}} | ||
<br><br> | <br><br> | ||
<small>§ EHEC, EIEC, EPEC and EAEC may cause bloody diarrhea, but they are classically associated with watery diarrhea.</small><br> | <small>§ EHEC, EIEC, EPEC and EAEC may cause bloody diarrhea, but they are classically associated with watery diarrhea.</small><br> | ||
<small>† | <small>† Both Salmonella and Yersinia can cause watery and or bloody diarrhea.</small><br> | ||
<small>‡ [[Entamoeba histolytica]] may cause dysentery</small> | <small>‡ [[Entamoeba histolytica]] may cause dysentery.</small> | ||
<nowiki>*</nowiki> <small>Mycobacterium sp is Gram Postive Acid fast.</small> | |||
<br /> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | {| class="wikitable sortable mw-collapsible" style="border: 0px; font-size: 90%; margin: 3px;" align="center" | ||
! colspan="3" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;"|Organism | |+ | ||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;"|Age predilection | ! colspan="3" rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Organism | ||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;"|Travel History | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Age predilection | ||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;"|Incubation Size (cell) | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Travel History | ||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;"|Incubation Time | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Incubation Size (cell) | ||
! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;"|History and Symptoms | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Incubation Time | ||
! colspan="4" align="center" style="background:#4479BA; color: #FFFFFF;"|Diarrhea type∞ | ! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |History and Symptoms | ||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;"|Food source | ! colspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" |Diarrhea type∞ | ||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;"|Specific consideration | ! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Food source | ||
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Specific consideration | |||
|- | |- | ||
!style="background:#4479BA; color: #FFFFFF|Fever | ! style="background:#4479BA; color: #FFFFFF" |Fever | ||
!style="background:#4479BA; color: #FFFFFF|N/V | ! style="background:#4479BA; color: #FFFFFF" |N/V | ||
!style="background:#4479BA; color: #FFFFFF|Cramping Abd Pain | ! style="background:#4479BA; color: #FFFFFF" |Cramping Abd Pain | ||
!style="background:#4479BA; color: #FFFFFF|Small Bowel | ! style="background:#4479BA; color: #FFFFFF" |Small Bowel | ||
!style="background:#4479BA; color: #FFFFFF|Large Bowel | ! style="background:#4479BA; color: #FFFFFF" |Large Bowel | ||
!style="background:#4479BA; color: #FFFFFF|Inflammatory | ! style="background:#4479BA; color: #FFFFFF" |Inflammatory | ||
!style="background:#4479BA; color: #FFFFFF|Non-inflammatory | ! style="background:#4479BA; color: #FFFFFF" |Non-inflammatory | ||
|- | |- | ||
| rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;"|'''Viral''' | | rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" |'''Viral''' | ||
| colspan="2" | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Rotavirus]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<2 y | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<2 y | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<10<sup>2</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<10<sup>2</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<48 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<48 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Mostly in day cares | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''Most common cause of diarrhea among children'''<ref name="pmid17204802">{{cite journal| author=Elliott EJ| title=Acute gastroenteritis in children. | journal=BMJ | year= 2007 | volume= 334 | issue= 7583 | pages= 35-40 | pmid=17204802 | doi=10.1136/bmj.39036.406169.80 | pmc=1764079 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17204802 }}</ref>'''.''' | ||
Mostly in day cares and in winter. | |||
|- | |- | ||
| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Norovirus]] | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Norovirus]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any age | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any age | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10 -10<sup>3</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10 -10<sup>3</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |24-48 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |24-48 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Most common cause of gastroenteritis | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''Most common cause of adult gastroenteritis.''' | ||
Common infection on cruise ships. | |||
<br /> | |||
|- | |- | ||
| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Adenoviridae|Adenovirus]] | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Adenoviridae|Adenovirus]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<2 y | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<2 y | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>5</sup> -10<sup>6</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>5</sup> -10<sup>6</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |8-10 d | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |8-10 d | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |No seasonality | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Associated with multiorgan involvement. | ||
No seasonality. | |||
|- | |- | ||
| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Astrovirus]] | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Astrovirus]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<5 y | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<5 y | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |72-96 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |72-96 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Seafood | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Seafood | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Mostly during winter | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Mostly during winter | ||
|- | |- | ||
| rowspan="11" align="center" style="background:#4479BA; color: #FFFFFF;"|'''Bacterial''' | | rowspan="11" align="center" style="background:#4479BA; color: #FFFFFF;" |'''Bacterial''' | ||
| rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Escherichia coli]]'' | | rowspan="5" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Escherichia coli]]'' | ||
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[ETEC]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[ETEC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any age | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any age | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>8</sup> -10<sup>10</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>8</sup> -10<sup>10</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |24 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |24 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Causes | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Causes [[Travelers diarrhea|traveler's diarrhea]]. | ||
Contains heat-labile toxins (LT) and heat-stable toxins (ST). | |||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EPEC]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EPEC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<1 y | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<1 y | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>†</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>†</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |6-12 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |6-12 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Raw beef and chicken | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Raw beef and chicken | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | Mostly affects pediatric population. | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EIEC]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EIEC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>†</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>†</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |24 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |24 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Hamburger meat and unpasteurized milk | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Hamburger meat and unpasteurized milk | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Similar to [[shigellosis]], can cause bloody diarrhea | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Similar to [[shigellosis]], can cause bloody diarrhea. | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EHEC]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EHEC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | (O157:H7) | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10 | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |3-4 d | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10 | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |3-4 d | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Undercooked or raw hamburger (ground beef) | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Undercooked or raw hamburger (ground beef) | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Can cause [[Hemolytic-uremic syndrome|HUS]]/[[TTP]]. | |||
Prescribing antibiotics may worsen the condition. | |||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EAEC]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EAEC]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>10</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>10</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |8-18 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |8-18 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause prolonged or persistent diarrhea in children | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause prolonged or persistent diarrhea in children | ||
|- | |- | ||
| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Salmonella|Salmonella sp.]]'' | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Salmonella|Salmonella sp.]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |1 | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |1 | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |6 to 72 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |6 to 72 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Meats, poultry, eggs, milk and dairy products, fish, shrimp, spices, yeast, coconut, sauces, freshly prepared salad. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Meats, poultry, eggs, milk and dairy products, fish, shrimp, spices, yeast, coconut, sauces, freshly prepared salad. | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Can cause [[salmonellosis]] or [[typhoid fever]]. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Can cause [[salmonellosis]] or [[typhoid fever]]. | ||
|- | |- | ||
| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Shigella|Shigella sp.]]'' | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Shigella|Shigella sp.]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10 - 200 | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10 - 200 | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |8-48 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |8-48 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Raw foods, for example, lettuce, salads (potato, tuna, shrimp, macaroni, and chicken) | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Raw foods, for example, lettuce, salads (potato, tuna, shrimp, macaroni, and chicken) | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Some strains produce enterotoxin and Shiga toxin similar to those produced by E. coli O157:H7 | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Some strains produce enterotoxin and Shiga toxin similar to those produced by [[Escherichia coli O157:H7|E. coli O157:H7]] | ||
|- | |- | ||
| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Campylobacter|Campylobacter sp.]]'' | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Campylobacter|Campylobacter sp.]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<5 y, 15-29 y | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<5 y, 15-29 y | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>4</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>4</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |2-5 d | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |2-5 d | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Undercooked poultry products, unpasteurized milk and cheeses made from unpasteurized milk, vegetables, seafood and contaminated water. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Undercooked poultry products, unpasteurized milk and cheeses made from unpasteurized milk, vegetables, seafood and contaminated water. | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause [[bacteremia]], [[Guillain-Barré syndrome]] (GBS), [[Hemolytic-uremic syndrome|hemolytic uremic syndrome]] (HUS) and recurrent [[colitis]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause [[bacteremia]], [[Guillain-Barré syndrome]] (GBS), [[Hemolytic-uremic syndrome|hemolytic uremic syndrome]] (HUS) and recurrent [[colitis]] | ||
|- | |- | ||
| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Yersinia enterocolitica]]'' | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Yersinia enterocolitica]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<10 y | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<10 y | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>4</sup> -10<sup>6</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>4</sup> -10<sup>6</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |1-11 d | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |1-11 d | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Meats (pork, beef, lamb, etc.), oysters, fish, crabs, and raw milk. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Meats (pork, beef, lamb, etc.), oysters, fish, crabs, and raw milk. | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Causes Pseudo-Appendicitis (due to [[mesenteric adenitis]] / granulomatous microabscesses). | ||
Also cause [[reactive arthritis]], [[glomerulonephritis|glomerulonephritis,]] [[endocarditis]], [[erythema nodosum|and erythema nodosum]]. | |||
|- | |- | ||
| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Clostridium perfringens]]'' | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Clostridium perfringens]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |> 10<sup>6</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |> 10<sup>6</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |16 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |16 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Meats (especially beef and poultry), meat-containing products (e.g., gravies and stews), and Mexican foods. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Meats (especially beef and poultry), meat-containing products (e.g., gravies and stews), and Mexican foods. | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Can survive high heat | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Can survive high heat. | ||
Also causes gas gangrene. | |||
|- | |- | ||
| colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Vibrio cholerae]]'' | | colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Vibrio cholerae]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>6</sup>-10<sup>10</sup> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10<sup>6</sup>-10<sup>10</sup> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |24-48 h | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |24-48 h | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki> | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Seafoods, including molluscan shellfish (oysters, mussels, and clams), crab, lobster, shrimp, squid, and finfish. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Seafoods, including molluscan shellfish (oysters, mussels, and clams), crab, lobster, shrimp, squid, and finfish. | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Endemic to developing countries. | ||
Typical rice-water stools. | |||
|- | |- | ||
| rowspan="7" align="center" style="background:#4479BA; color: #FFFFFF;"|'''Parasites''' | | rowspan="7" align="center" style="background:#4479BA; color: #FFFFFF;" |'''Parasites''' | ||
| rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Protozoa | | rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Protozoa | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Giardia lamblia]]'' | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Giardia lamblia]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |2-5 y | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |2-5 y | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |1 cyst | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |1 cyst | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |1-2 we | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |1-2 we | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Contaminated water | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Contaminated water (chlorination does not kill the cysts) | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause [[malabsorption syndrome]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause [[malabsorption syndrome]] leading to severe [[weight loss]]. | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Entamoeba histolytica]]'' | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Entamoeba histolytica]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |4-11 y | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |4-11 y | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |<10 cysts | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<10 cysts | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |2-4 we | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |2-4 we | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Contaminated water and raw foods | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Contaminated water and raw foods | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause intestinal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause intestinal [[amoebiasis]] and [[amoebic liver abscess]] with characteristic <nowiki>''Anchovy paste''</nowiki> abscess. | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Cryptosporidium parvum]]'' | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Cryptosporidium parvum]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10-100 oocysts | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10-100 oocysts | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |7-10 d | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |7-10 d | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Juices and milk | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Juices and milk | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Most common cause of diarrhea in [[HIV AIDS|AIDS]] patients( especially with CD4 < 180). | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Cyclospora cayetanensis]]'' | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Cyclospora cayetanensis]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |10-100 oocysts | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |10-100 oocysts | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |7-10 d | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |7-10 d | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Fresh produce, such as raspberries, basil, and several varieties of lettuce. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Fresh produce, such as raspberries, basil, and several varieties of lettuce. | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |More common in rainy areas | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |More common in rainy areas | ||
|- | |- | ||
| rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Helminths | | rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Helminths | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Trichinella]]'' [[Trichinella|spp]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Trichinella]]'' [[Trichinella|spp]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Two viable larvae (male and female) | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Two viable larvae (male and female) | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |1-4 we | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |1-4 we | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Undercooked meats | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Undercooked meats | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |More common in hunters or people who eat traditionally uncooked meats | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |More common in hunters or people who eat traditionally uncooked meats | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Taenia (tapeworm)|Taenia]]'' [[Taenia (tapeworm)|spp]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Taenia (tapeworm)|Taenia]]'' [[Taenia (tapeworm)|spp]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |1 larva or egg | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |1 larva or egg | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |2-4 m | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |2-4 m | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Undercooked beef and pork | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Undercooked beef and pork | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Neurocysticercosis]]: Cysts located in the brain may be asymptomatic or [[seizures]], increased [[intracranial pressure]], [[headache]]. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Neurocysticercosis]]: Cysts located in the brain may be asymptomatic or [[seizures]], increased [[intracranial pressure]], [[headache]]. | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Diphyllobothrium|Diphyllobothrium latum]]'' | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |''[[Diphyllobothrium|Diphyllobothrium latum]]'' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Any ages | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |1 larva | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |1 larva | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |15 d | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |15 d | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Raw or undercooked fish. | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Raw or undercooked fish. | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause vitamin B<sub>12</sub> deficiency | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |May cause [[Vitamin B12 deficiency|vitamin B<sub>12</sub> deficiency]] | ||
|} | |} | ||
<br><br> | <br><br> | ||
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==Prevention== | ==Prevention== | ||
===Non travel setting=== | ===Non travel setting=== | ||
*Contaminated foods are major causes of foodborne illness in the United states.<ref name="pmid21192849">{{cite journal |vauthors=Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM |title=Foodborne illness acquired in the United States--unspecified agents |journal=Emerging Infect. Dis. |volume=17 |issue=1 |pages=16–22 |year=2011 |pmid=21192849 |pmc=3204615 |doi=10.3201/eid1701.091101p2 |url=}}</ref><ref name="pmid21192848">{{cite journal |vauthors=Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM |title=Foodborne illness acquired in the United States--major pathogens |journal=Emerging Infect. Dis. |volume=17 |issue=1 |pages=7–15 |year=2011 |pmid=21192848 |pmc=3375761 |doi=10.3201/eid1701.091101p1 |url=}}</ref> | *Contaminated foods are major causes of [[foodborne illness]] in the United states.<ref name="pmid21192849">{{cite journal |vauthors=Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM |title=Foodborne illness acquired in the United States--unspecified agents |journal=Emerging Infect. Dis. |volume=17 |issue=1 |pages=16–22 |year=2011 |pmid=21192849 |pmc=3204615 |doi=10.3201/eid1701.091101p2 |url=}}</ref><ref name="pmid21192848">{{cite journal |vauthors=Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM |title=Foodborne illness acquired in the United States--major pathogens |journal=Emerging Infect. Dis. |volume=17 |issue=1 |pages=7–15 |year=2011 |pmid=21192848 |pmc=3375761 |doi=10.3201/eid1701.091101p1 |url=}}</ref> | ||
*To prevent food preparation chain from contamination, every steps of this process including, products in the farms, packaging industries, stores, restaurants and individuals in the home who are buying and preparing food must be take in to consideration. | *To prevent food preparation chain from contamination, every steps of this process including, products in the farms, packaging industries, stores, restaurants and individuals in the home who are buying and preparing food must be take in to consideration. | ||
*Proper maintaining the filtration systems at water plants is also essential. | *Proper maintaining the filtration systems at water plants is also essential. | ||
*Avoid consuming unpasteurized milk or soft cheeses. | *Avoid consuming unpasteurized milk or soft cheeses. | ||
*Wash your hands frequently and effectively and use alcohol-based hand sanitizers. | *Wash your hands frequently and effectively and use alcohol-based hand sanitizers. | ||
*[[Rotavirus]] vaccination is recommended for all infants unless there is a contraindication for it.<ref name="pmid19194371">{{cite journal |vauthors=Cortese MM, Parashar UD |title=Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP) |journal=MMWR Recomm Rep |volume=58 |issue=RR-2 |pages=1–25 |year=2009 |pmid=19194371 |doi= |url=}}</ref> | *[[Rotavirus]] vaccination is recommended for all infants unless there is a [[contraindication]] for it.<ref name="pmid19194371">{{cite journal |vauthors=Cortese MM, Parashar UD |title=Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP) |journal=MMWR Recomm Rep |volume=58 |issue=RR-2 |pages=1–25 |year=2009 |pmid=19194371 |doi= |url=}}</ref> | ||
===Travel setting=== | ===Travel setting=== | ||
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{{reflist|2}} | {{reflist|2}} | ||
[[Category:Disease | [[Category:Disease]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Up-To-Date | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Emergency medicine]] | |||
[[Category:Pediatrics]] |
Latest revision as of 21:49, 29 July 2020
![]() |
Resident Survival Guide |
For Gastroentritis patient information click here
Gastroenteritis Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Acute gastroenteritis and diarrhea are among the leading causes of seeking medical care. Approximately, 48 million cases occur annually that cost about $150 million for the U.S. health care system. [1][2] Gastroenteritis is defined as inflammation of the stomach or intestinal mucosa. It typically presents with acute diarrhea, fever, nausea and vomiting, anorexia and crampy abdominal pain and is defined as passage of loose stool for at least 3 times per day for less than 14 days. It may be caused by viruses, bacteria or parasites. Most cases of acute gastroenteritis are caused by viruses and among them, norovirus (norwalk virus) is the most common etiology for adults.[3][4][5] Other common viral causes include, Rotavirus, Adenovirus and Astrovirus. Common bacterial causes of gastroenteritis include, Escherichia coli sp, Salmonella sp, Yersinia enterocolitica and Vibrio sp that can cause watery diarrhea and Shigella sp and Campylobacter sp that can cause dysenteric diarrhea. Parasites are other causes of gastroenteritis especially in developing countries which Giardia lamblia and Entamoeba histolytica are the most frequent causes. First step in management of this patients is to evaluate the hydration status and vital signs. Once the patient is stabilized, health care provider must proceed to diagnostic evaluation. There are some principles to decrease the risk of acquiring infection which include, using safe water and foods, avoid unsafe foods during traveling and hand washing.
Classification
Abbreviations:
ETEC: Enterotoxigenic Escherichia coli, EPEC: Enteropathogenic Escherichia coli, EHEC: Enterohemorrhagic Escherichia coli, EAEC: Enteroaggregative Escherichia coli, EIEC: Enteroinvasive Escherichia coli, SARS: severe acute respiratory syndrome
Gastroenteritis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Viral | Bacterial | Parasites | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Common | Less Common | Common | Less Common | Helminthic | Protozoal | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
•Rotavirus •Norovirus • Adenovirus •Astroviruses | •Enterovirus •Coronavirus (including SARS) •Parvovirus •Kobuviruses •Orthoreovirus •Torovirus | Gram Positive | Gram Negative | Gram Positive | Gram Negative | •Trichinella spiralis •Trichuris trichiura •Strongyloides stercoralis •Taenia solium •Taenia saginata •Diphyllobothrium latum •Schistosoma mansoni | •Giardia lamblia •Entamoeba histolytica‡ •Cryptosporidium parvum •Cyclospora cayetanensis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
•Clostridium perfringens •Clostridium difficile | Bloody diarrhea (dysentery) | Watery diarrhea | • Bacillus cereus • Listeria monocytogenes | •Bacteroides fragilis •Aeromonas hydrophila | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
•Campylobacter sp.
•Shigella sp. •Escherichia coli (EHEC, EIEC) •Salmonella(non-typhoidal) sp.† | •Escherichia coli (ETEC, EPEC, EAEC) •Salmonella(typhoidal) sp.† | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
§ EHEC, EIEC, EPEC and EAEC may cause bloody diarrhea, but they are classically associated with watery diarrhea.
† Both Salmonella and Yersinia can cause watery and or bloody diarrhea.
‡ Entamoeba histolytica may cause dysentery.
* Mycobacterium sp is Gram Postive Acid fast.
Differential Diagnosis
Organism | Age predilection | Travel History | Incubation Size (cell) | Incubation Time | History and Symptoms | Diarrhea type∞ | Food source | Specific consideration | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Fever | N/V | Cramping Abd Pain | Small Bowel | Large Bowel | Inflammatory | Non-inflammatory | |||||||||
Viral | Rotavirus | <2 y | - | <102 | <48 h | + | + | - | + | + | - | Most common cause of diarrhea among children[6].
Mostly in day cares and in winter. | |||
Norovirus | Any age | - | 10 -103 | 24-48 h | + | + | + | + | + | - | Most common cause of adult gastroenteritis.
Common infection on cruise ships.
| ||||
Adenovirus | <2 y | - | 105 -106 | 8-10 d | + | + | + | + | + | - | Associated with multiorgan involvement.
No seasonality. | ||||
Astrovirus | <5 y | - | 72-96 h | + | + | + | + | + | Seafood | Mostly during winter | |||||
Bacterial | Escherichia coli | ETEC | Any age | + | 108 -1010 | 24 h | - | + | + | + | + | - | Causes traveler's diarrhea.
Contains heat-labile toxins (LT) and heat-stable toxins (ST). | ||
EPEC | <1 y | - | 10† | 6-12 h | - | + | + | + | + | Raw beef and chicken | Mostly affects pediatric population. | ||||
EIEC | Any ages | - | 10† | 24 h | + | + | + | + | + | Hamburger meat and unpasteurized milk | Similar to shigellosis, can cause bloody diarrhea. | ||||
EHEC
(O157:H7) |
Any ages | - | 10 | 3-4 d | - | + | + | + | + | Undercooked or raw hamburger (ground beef) | Can cause HUS/TTP.
Prescribing antibiotics may worsen the condition. | ||||
EAEC | Any ages | + | 1010 | 8-18 h | - | - | + | + | + | - | May cause prolonged or persistent diarrhea in children | ||||
Salmonella sp. | Any ages | + | 1 | 6 to 72 h | + | + | + | + | + | Meats, poultry, eggs, milk and dairy products, fish, shrimp, spices, yeast, coconut, sauces, freshly prepared salad. | Can cause salmonellosis or typhoid fever. | ||||
Shigella sp. | Any ages | - | 10 - 200 | 8-48 h | + | + | + | + | + | Raw foods, for example, lettuce, salads (potato, tuna, shrimp, macaroni, and chicken) | Some strains produce enterotoxin and Shiga toxin similar to those produced by E. coli O157:H7 | ||||
Campylobacter sp. | <5 y, 15-29 y | - | 104 | 2-5 d | + | + | + | + | + | Undercooked poultry products, unpasteurized milk and cheeses made from unpasteurized milk, vegetables, seafood and contaminated water. | May cause bacteremia, Guillain-Barré syndrome (GBS), hemolytic uremic syndrome (HUS) and recurrent colitis | ||||
Yersinia enterocolitica | <10 y | - | 104 -106 | 1-11 d | + | + | + | + | + | Meats (pork, beef, lamb, etc.), oysters, fish, crabs, and raw milk. | Causes Pseudo-Appendicitis (due to mesenteric adenitis / granulomatous microabscesses).
Also cause reactive arthritis, glomerulonephritis, endocarditis, and erythema nodosum. | ||||
Clostridium perfringens | Any ages | > 106 | 16 h | - | - | + | + | + | Meats (especially beef and poultry), meat-containing products (e.g., gravies and stews), and Mexican foods. | Can survive high heat.
Also causes gas gangrene. | |||||
Vibrio cholerae | Any ages | - | 106-1010 | 24-48 h | - | + | + | + | + | Seafoods, including molluscan shellfish (oysters, mussels, and clams), crab, lobster, shrimp, squid, and finfish. | Endemic to developing countries.
Typical rice-water stools. | ||||
Parasites | Protozoa | Giardia lamblia | 2-5 y | + | 1 cyst | 1-2 we | - | - | + | + | + | Contaminated water (chlorination does not kill the cysts) | May cause malabsorption syndrome leading to severe weight loss. | ||
Entamoeba histolytica | 4-11 y | + | <10 cysts | 2-4 we | - | + | + | + | + | Contaminated water and raw foods | May cause intestinal amoebiasis and amoebic liver abscess with characteristic ''Anchovy paste'' abscess. | ||||
Cryptosporidium parvum | Any ages | - | 10-100 oocysts | 7-10 d | + | + | + | + | + | Juices and milk | Most common cause of diarrhea in AIDS patients( especially with CD4 < 180). | ||||
Cyclospora cayetanensis | Any ages | + | 10-100 oocysts | 7-10 d | - | + | + | + | + | Fresh produce, such as raspberries, basil, and several varieties of lettuce. | More common in rainy areas | ||||
Helminths | Trichinella spp | Any ages | - | Two viable larvae (male and female) | 1-4 we | - | + | + | + | + | Undercooked meats | More common in hunters or people who eat traditionally uncooked meats | |||
Taenia spp | Any ages | - | 1 larva or egg | 2-4 m | - | + | + | + | + | Undercooked beef and pork | Neurocysticercosis: Cysts located in the brain may be asymptomatic or seizures, increased intracranial pressure, headache. | ||||
Diphyllobothrium latum | Any ages | - | 1 larva | 15 d | - | - | - | + | + | Raw or undercooked fish. | May cause vitamin B12 deficiency |
∞Small bowel diarrhea: watery, voluminous with less than 5 WBC/high power field
Large bowel diarrhea: Mucousy and/or bloody with less volume and more than 10 WBC/high power field
† It could be as high as 1000 based on patient's immunity system.
Prevention
Non travel setting
- Contaminated foods are major causes of foodborne illness in the United states.[1][2]
- To prevent food preparation chain from contamination, every steps of this process including, products in the farms, packaging industries, stores, restaurants and individuals in the home who are buying and preparing food must be take in to consideration.
- Proper maintaining the filtration systems at water plants is also essential.
- Avoid consuming unpasteurized milk or soft cheeses.
- Wash your hands frequently and effectively and use alcohol-based hand sanitizers.
- Rotavirus vaccination is recommended for all infants unless there is a contraindication for it.[7]
Travel setting
- A simple rule is, boil it, cook it, peel it, or forget it!
- Use bottled water or boil all drinking water while on outdoor adventures.
- Wash your hands frequently and effectively and use alcohol-based hand sanitizers especially during cruise traveling.
- Chemoprophylaxis with Bismuth subsalicylate (BSS) has been shown to reduce the frequency of traveler's diarrhea (TD) when used during period of risk for 3 weeks.[8] The recommended dose of BSS for TD prevention is two tablets four daily doses at mealtimes and at bedtime. BSS could be used for trips up to 2 weeks.[9]
- Offer the typhoid vaccine to travelers going to countries with high prevalence of typhoid fever.
References
- ↑ 1.0 1.1 Scallan E, Griffin PM, Angulo FJ, Tauxe RV, Hoekstra RM (2011). "Foodborne illness acquired in the United States--unspecified agents". Emerging Infect. Dis. 17 (1): 16–22. doi:10.3201/eid1701.091101p2. PMC 3204615. PMID 21192849.
- ↑ 2.0 2.1 Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM (2011). "Foodborne illness acquired in the United States--major pathogens". Emerging Infect. Dis. 17 (1): 7–15. doi:10.3201/eid1701.091101p1. PMC 3375761. PMID 21192848.
- ↑ Bresee JS, Marcus R, Venezia RA, Keene WE, Morse D, Thanassi M, Brunett P, Bulens S, Beard RS, Dauphin LA, Slutsker L, Bopp C, Eberhard M, Hall A, Vinje J, Monroe SS, Glass RI (2012). "The etiology of severe acute gastroenteritis among adults visiting emergency departments in the United States". J. Infect. Dis. 205 (9): 1374–81. doi:10.1093/infdis/jis206. PMID 22454468.
- ↑ Hall AJ, Rosenthal M, Gregoricus N, Greene SA, Ferguson J, Henao OL, Vinjé J, Lopman BA, Parashar UD, Widdowson MA (2011). "Incidence of acute gastroenteritis and role of norovirus, Georgia, USA, 2004-2005". Emerging Infect. Dis. 17 (8): 1381–8. doi:10.3201/eid1708.101533. PMC 3381564. PMID 21801613.
- ↑ Wikswo ME, Hall AJ (2012). "Outbreaks of acute gastroenteritis transmitted by person-to-person contact--United States, 2009-2010". MMWR Surveill Summ. 61 (9): 1–12. PMID 23235338.
- ↑ Elliott EJ (2007). "Acute gastroenteritis in children". BMJ. 334 (7583): 35–40. doi:10.1136/bmj.39036.406169.80. PMC 1764079. PMID 17204802.
- ↑ Cortese MM, Parashar UD (2009). "Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP)". MMWR Recomm Rep. 58 (RR-2): 1–25. PMID 19194371.
- ↑ DuPont HL, Sullivan P, Evans DG, Pickering LK, Evans DJ, Vollet JJ, Ericsson CD, Ackerman PB, Tjoa WS (1980). "Prevention of traveler's diarrhea (emporiatric enteritis). Prophylactic administration of subsalicylate bismuth)". JAMA. 243 (3): 237–41. PMID 6985681.
- ↑ DuPont HL, Ericsson CD, Farthing MJ, Gorbach S, Pickering LK, Rombo L, Steffen R, Weinke T (2009). "Expert review of the evidence base for prevention of travelers' diarrhea". J Travel Med. 16 (3): 149–60. doi:10.1111/j.1708-8305.2008.00299.x. PMID 19538575.