Summary
Definition
History and exam
Key diagnostic factors
- diarreia
- história de viagens, contato com alimentos contaminados ou contato com pessoas infectadas
Other diagnostic factors
- dor ou desconforto abdominal
- depleção de volume
- febre
- náuseas/vômitos
- anorexia
- letargia
Risk factors
- ingestão de produtos alimentícios ou de água contaminada
- viagens
- práticas de higiene precárias
- infantil ou idade avançada (<5 anos e >60 anos)
- história de contato
- pacientes imunocomprometidos
- contato com animais infectados
Diagnostic investigations
1st investigations to order
- coproculturas
- Hemograma completo
- função renal e eletrólitos
Investigations to consider
- identificação da infecção por E coli produtora de toxina Shiga
- hemoculturas
- marcadores inflamatórios (proteína C-reativa e/ou velocidade de hemossedimentação)
- radiografia abdominal
- endoscopia
- tomografia computadorizada (TC) abdominal
Treatment algorithm
todos os pacientes
bactéria enterotoxigênica positiva confirmada
bactéria êntero-hemorrágica positiva confirmada
outros sorotipos de Escherichia coli
Contributors
Authors
Eli D. Ehrenpreis, MD, FACG, AGAF
Associate Director for Research
Internal Medicine Residency
Advocate Lutheran General Hospital
Park Ridge
IL
Disclosures
EDE is a CEO for E2Bio Life Sciences LLC and G.I. Pharmaceuticals Inc. E2Bio Life Sciences LLC has developed Bocaliner, an FDA-registered class 1 medical device designed to enhance the efficacy of topical medicines applied to the oral cavity. G.I. Pharmaceuticals Inc. has medical treatments for oral leukoplakia designed to prevent oral cancer, and a new medicine for anal pruritis.
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.
References
Key articles
Nataro JP, Kaper JB. Diarrheagenic Escherichia coli. Clin Microbiol Rev. 1998 Jan;11(1):142-201.Full text Abstract
Kaper JB, Nataro JP, Mobley HL. Pathogenic Escherichia coli. Nat Rev Microbiol. 2004 Feb;2(2):123-40.Full text Abstract
American Medical Association; American Nurses Association-American Nurses Foundation; Centers for Disease Control and Prevention; Center for Food Safety and Applied Nutrition, Food and Drug Administration; Food Safety and Inspection Service, US Department of Agriculture. Diagnosis and management of foodborne illnesses: a primer for physicians and other health care professionals. MMWR Recomm Rep. 2004 Apr 16;53(RR-4):1-33.Full text Abstract
Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-e80.Full text Abstract
Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 2: preparing international travelers - travelers' diarrhea. May 2023 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Gastroenterite viral
- Gastroenterite/diarreia do viajante bacteriana de origem alimentar alternativa
- Amebíase
More DifferentialsGuidelines
- Infectious diarrhea - guideline for investigation
- E. coli (Escherichia coli) infection
More GuidelinesPatient information
Diarreia em crianças
Diarreia em adultos
More Patient information
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