Topic Info - BotMed Application

TopicName

Acute diarrhea

ClinicalTests

CBC (anemia or leukocytosis);
FOBT (blood in stool);
Stool (Ova and/or parasites);
Stool leukocytes (inflammatory diarrhea);
AST/ALT/bilirubin;
Stool culture (Identify bacteria, viruses, fungi, or parasites in stool often in the context of a suspected gastrointestinal infection) - expensive and have low sensitivity;
C. difficile toxin assay (unexplained diarrhea after three days of hospitalization);
Electrolytes; 

Check WBC and RBC to eliminate infections:
With blood: 
Campylobacter; 
E.coli; 
Salmonella; 
Shigella; 
Yersinia;

No blood:
Staph (with Vomiting);
B.Ceries (with Vomiting);
Giardia (campers) – ELISA antigens;
Crypto (HIV positive) <100CD4, modified acid fast stain;
Clost.Def.(after antibiotics) – toxin is diagnostic test, NOT CULTURE!!
V.parahem – shellfish;
Rotavirus – most common in young children;

ImagingStudies

PhysicalExams

Assess the patient's degree of dehydration: dry mucous membranes, delayed capillary refill time, increased heart rate, and abnormal orthostatic vital signs.
Fever is more suggestive of inflammatory diarrhea. 
The abdominal examination is important to assess for pain and acute abdominal processes. 
A rectal examination may be helpful in assessing for blood, rectal tenderness, and stool consistency.

Comment

Acute: <14 days
R/F: Diarrhea lasting > 3 days;
High fever (>39C)
Blood in stools;
Suspicion of IBD;
Frequent vomiting, signs of dehydration: little or no urine; very dry mouth and throat; feeling dizzy when standing up;
Immunosuppression.
Viral; parasitic; bacterial; food poisoning; HIV patient; recent travel;

WebLink

https://www.aafp.org/afp/2014/0201/p180.html