小结
定义
病史和体格检查
关键诊断因素
- 腹泻
- 旅行史、污染食品摄入史或与感染患者的接触史
其他诊断因素
- 腹痛或腹部不适
- 容量减少
- 发热
- 恶心/呕吐
- 厌食
- 昏睡
危险因素
- 摄入被污染的食品或水
- 旅行
- 不良卫生习惯
- 婴儿或老年（<5 岁和 >60 岁）
- 接触史
- 免疫功能受损状态
- 接触感染动物
诊断性检查
首要检查
- 粪便培养
- 全血细胞计数 (FBC）
- 肾功能和电解质
需考虑的检查
- 产志贺毒素大肠埃希菌感染的识别
- 血液培养
- 炎症标志物（CRP 和/或红细胞沉降率）
- 腹部 X 线检查
- 内镜检查
- 腹部 CT 扫描
治疗流程
所有患者
肠产毒性大肠埃希菌明确阳性
肠出血性大肠埃希菌明确阳性
其他大肠杆菌血清型
撰稿人
作者
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
利益声明
EDE is CEO for E2Bio Life Sciences LLC, and CEO for G.I. Pharmaceuticals Inc.
鸣谢
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.
利益声明
TAW, AK, and SK declare that they have no competing interests.
同行评议者
Andrew Poullis, BSc, MBBS, MD, FRCP
Consultant Gastroenterologist
St George’s Hospital
London
UK
利益声明
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
利益声明
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
利益声明
HEM declares that he has no competing interests.
鉴别诊断
- 病毒性胃肠炎
- 其他的食源性细菌性胃肠炎/旅行者腹泻
- 阿米巴病
更多 鉴别诊断指南
- 产志贺毒素大肠杆菌：指南、数据和分析
- 2017 年美国传染病学会 (Infectious Diseases Society of America) 感染性腹泻诊疗临床实践指南
更多 指南患者教育信息
Diarrhoea in adults
Diarrhoea in children
更多 患者教育信息
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