Clinical Presentations Suggestive of Infectious Diarrhea Etiologies • Persistent or chronic diarrhea - Cryptosporidium spp, Giardia lamblia, Cyclospora cayetanensis, Cystoisospora belli, and Entamoeba histolytica • Visible blood in stool - STEC, Shigella, Salmonella, Campylobacter, Entamoeba histolytica, noncholera Vibrio species, Yersinia, Balantidium coli, Plesiomonas • Fever - Not highly discriminatory—viral, bacterial, and parasitic infections can cause fever. In general, higher temperatures are suggestive of bacterial etiology or E. histolytica. Patients infected with STEC usually are not febrile at time of presentation • Abdominal pain - STEC, Salmonella, Shigella, Campylobacter, Yersinia, noncholera Vibrio species, Clostridium difficile • Severe abdominal pain, often grossly bloody stools (occasionally nonbloody), and minimal or no fever - STEC, Salmonella, Shigella, Campylobacter, and Yersinia enterocolitica • Persistent abdominal pain and fever - Y. enterocolitica and Y. pseudotuberculosis; may mimic appendicitis • Nausea and vomiting lasting ≤24 hours - Ingestion of Staphylococcus aureus enterotoxin or Bacillus cereus (short-incubation emetic syndrome) • Diarrhea and abdominal cramping lasting 1–2 days - Ingestion of Clostridium perfringens or B. cereus (long incubation emetic syndrome) • Vomiting and nonbloody diarrhea lasting 2–3 days or less - Norovirus (low-grade fever usually present during the first 24 hours in 40% if infections) • Chronic watery diarrhea, often lasting a year or more - Brainerd diarrhea (etiologic agent has not been identified); postinfectious irritable bowel syndrome #Infectious #Diarrhea #diagnosis #differential #presentations
