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Intoxicação alimentar

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 18 Aug 2025
Last updated: 08 Dec 2023

Summary

定义

病史和体格检查

关键诊断因素

  • presença de fatores de risco
  • diarreia
  • náuseas e vômitos
完整详情

其他诊断因素

  • dor abdominal
  • distensão abdominal
  • febre
  • desidratação
  • sangue ou muco nas fezes
  • fezes profusas com aspecto de "água de arroz"
  • artrite reativa
  • manifestações cutâneas
  • Manifestações de orelha, nariz e garganta
  • hepatoesplenomegalia
  • manifestações neurológicas
  • doença hepatobiliar
  • sintomas pulmonares
  • outras características intestinais
  • manifestações de infecções ectópicas
完整详情

危险因素

  • idosos e gestantes
  • doenças crônicas
  • história de viagem recente
  • pacientes imunocomprometidos
  • história de contato com outros indivíduos com intoxicação alimentar
  • consumo de carne malcozida
  • consumo de frutos do mar crus
  • consumo de alimentos em conserva caseira
  • consumo de queijos frescos não pasteurizados
  • consumo de embutidos
  • consumo de leite ou suco não pasteurizado
  • consumo de ovos crus
  • manuseio e armazenamento inadequado dos alimentos
  • supressão de ácido gástrico
完整详情

诊断性检查

首要检查

  • microscopia das fezes para leucócitos e eritrócitos
  • coprocultura
  • exame de fezes para detecção de ovos e parasitas
  • reação em cadeia da polimerase de fezes
  • Hemograma completo com diferencial
  • eletrólitos e creatinina sérica
  • proteína C-reativa
完整详情

需考虑的检查

  • exame de detecção da toxina botulínica
  • hemocultura
  • lipase e amilase séricas
  • TFHs
  • anticorpos imunoglobulina M (IgM) da hepatite A
  • anticorpos IgM da hepatite E
  • série radiográfica do abdome agudo
  • sigmoidoscopia/colonoscopia
  • endoscopia digestiva alta
  • biópsia
  • teste do barbante (enteroteste)
  • aspirado duodenal
完整详情

治疗流程

初步治疗

doença leve a moderada

doença grave

suspeita de botulismo de origem alimentar

急症处理

organismo infeccioso conhecido

撰稿人

作者

Philip Allan, MBBS, DPhil, FRCP

Consultant Gastroenterologist

Department of Gastroenterology

John Radcliffe Hospital

Oxford

UK

利益声明

PA has consulted for Takeda (Shire) and BaxterHealthcare. PA has received travel, accommodation, and conference fees from Takeda (Shire).

鸣谢

Dr Philip Allan would like to gratefully acknowledge Dr Satish Keshav, Dr Michael Bennish, Dr Willem J.S. de Villiers, and Dr Houssam E. Mardini, the previous contributors to this topic. Unfortunately, we have been made aware that Dr Satish Keshav has passed away.

利益声明

MB received funds, salary, and/or research funding greater than 6 figures USD. MB declares that he has no other competing interests. WJSDV and HEM declare that they have no competing interests.

同行评议者

Franz Allerberger, MD, MPH

Professor of Clinical Microbiology

Austrian Agency for Health and Food Safety (AGES)

Vienna

Austria

利益声明

FA declares that he has no competing interests.

Nancy Crum-Cianflone, MD, MPH

Department Head

Naval Health Research Center

San Diego

CA

利益声明

NCC declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

American Medical Association, American Nurses Association/American Nurses Foundation, Centers for Disease Control and Prevention, et al. 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.全文  摘要

World Health Organization. Foodborne disease outbreaks: guidelines for investigation and control. 2008 [internet publication].全文

Public Health England. UK Standards for microbiology investigations S 7: gastroenteritis. Oct 2020 [internet publication].全文

Centers for Disease Control and Prevention. Food safety. Aug 2023 [internet publication].全文

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):e45-80.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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