Last reviewed: 25 Sep 2021
Last updated: 11 Aug 2021

Summary

Definition

History and exam

Key diagnostic factors

  • diarrhoea
  • history of travel, contact with contaminated food, or contact with infected person

Other diagnostic factors

  • abdominal pain or discomfort
  • volume depletion
  • fever
  • nausea/vomiting
  • anorexia
  • lethargy

Risk factors

  • ingestion of contaminated food products or water
  • travel
  • poor hygiene practices
  • infantile or advanced age (<5 years and >60 years)
  • contact history
  • immunocompromised state
  • contact with infected animals

Diagnostic investigations

1st investigations to order

  • stool cultures
  • FBC
  • renal function and electrolytes

Investigations to consider

  • identification of shiga toxin-producing E coli infection
  • blood cultures
  • inflammatory markers (CRP and/or erythrocyte sedimentation rate)
  • abdominal x-ray
  • endoscopy
  • abdominal CT scan

Treatment algorithm

Contributors

Authors

Eli D. Ehrenpreis, MD, FACG, AGAF

Professor of Medicine

Rosalind Franklin University Medical School

North Chicago

IL

Associate Director for Research

Internal Medicine Residency

Advocate Lutheran General Hospital

Park Ridge

IL

Disclosures

EDE is CEO for E2Bio Life Sciences LLC, and CEO for G.I. Pharmaceuticals Inc.

Acknowledgements

Dr Eli D. Ehrenpreis would like to gratefully acknowledge the assistance of Dr Thomas Adam Wichelmann, who contributed to this update. Dr Ehrenpreis would also like to acknowledge Dr Alexandra Kent and Professor Satis Keshav, the previous contributors to this topic.

Disclosures

TAW, AK, and SK declare that they have no competing interests.

Peer reviewers

Andrew Poullis, BSc, MBBS, MD, FRCP

Consultant Gastroenterologist

St George’s Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

Fiona Cooke, MA, PhD, MSc, FRCPath, MRCP, DTM&H

Research Fellow and Medical Microbiologist

Wellcome Trust Sanger Institute

Department of Microbiology

Addenbrooke's Hospital

Cambridge

UK

Disclosures

FC declares that she has no competing interests.

Houssam E. Mardini, MD, MPH, FACP

Voluntary Assistant Professor of Medicine

Digestive Health & Nutrition Center of Ashland

Ashland

KY

Disclosures

HEM declares that he has no competing interests.

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