Ver el código de «Acute gastroenteritis»

{{Adult top}} [[acute gastroenteritis (peds)]].''
==Background==
*Blood diarrhea suggests bacterial etiology
*Viral AGE usually lasts <7d
*Do not diagnose isolated vomiting as AGE

===Causes===

{| class="wikitable"
|+ Noninvasive AGE
|-
! Species!! Onset !! Symptoms !! Transmission !! Preformed Toxin
|-
| [[viruses|Viral]] ([[norovirus]], [[adenovirus]], [[rotavirus]])
|| 11-72 hrs
|| 
*Nausea, vomiting, watery diarrhea
*Mild abdominal cramps, myalgia
|| 
*Fecal-oral 
*Contaminated food or water
|| No
|-
| [[S. aureus|Staph]]
|| 1-6 hrs
|| 
*Nausea, severe vomiting, diarrhea, 
*Mild abdominal cramping
|| 
*Previously cooked foods (mayonaise, ham, salads)
|| Yes
|-
| [[Bacillus cereus|B. cereus]]
|| 1-6 hrs
|| 
*Abrupt onset of nausea, vomiting, mild diarrhea
|| 
*Previously cooked foods (rice, vegetables, dried fruits, meat)
|| Yes
|-
| [[Clostridium (not difficile)|C. perfringens]]
|| 8-24 hrs
|| 
*Nausea, minimal vomiting, watery diarrhea
*Abd cramps
|| 
*Previously cooked or reheated meats and poultry
|| Yes
|-
| [[Vibrio cholera|V. cholerae]]|| 11-72 hrs || 
*Explosive rice-water diarrhea
*Vomiting, abdominal cramps
*Fever
|| 
*Fecal-oral 
*Contaminated food or water 
|| Yes
|-
| [[Giardia]]
|| 1-4 wks
|| 
*Flatus, bloating
*Foul-smelling and fatty stools (steatorrhea)
|| 
*Fecal-oral
*Contaminated water
|| No
|}

{| class="wikitable sortable"
|+ Invasive AGE
|-
! scope="col" | '''Species'''
! scope="col" | '''Onset'''
! scope="col" | '''Symptoms'''
! scope="col" | '''Transmission'''
|-
| [[Salmonella]]||6-72 hours||
*[[Fever]], relative bradycardia
*[[Abdominal pain]]
*Bloody diarrhea
*[[Headache]]
*Osteomyelitis in sickle cell
||
*Eggs
*Poultry
*Water
*Reptiles
|-
| [[Shigella]]||1-3 days||
*[[Fever]]
*[[Abdominal pain]]
*Bloody diarrhea
*[[Headache]]
*1-5 years old
*Seizures in children
||
*Food
*Fecal-Oral
|-
| [[Yersinia]]||1-5 days||
*[[Appendicitis]] mimic, [[RLQ pain]]
*[[Fever]]
*[[Vomiting]]
*Kids and Young Adults
||
*Water
*Milk
*Pork
*Wild Animals
*Fecal-Oral
|-
| [[Campylobacter]]||1-7 days||
*Low grade [[fever]]
*[[Abdominal pain]]
*Kids and Young Adults
*Guillain-Barre
||
*Water
*Poultry
*Pets/Animals
|-
| [[C. Diff]]||1-11 Weeks||
*Copious FOUL diarrhea
||
*Antibiotic use: [[PCN]], [[Clinda]], [[Cephalosporins]]
|-
| [[Entamoeba]]||1-11 weeks||
*[[Appendicitis]] Mimic
*[[Abdominal pain]], [[nausea/vomiting]], [[diarrhea]]
||
*Water
*Sanitation
*Travel
|}

==Clinical Features==
*[[Vomiting]]/[[diarrhea]]
*Crampy/diffuse [[abdominal pain]]

==Differential Diagnosis==
{{Nausea and vomiting DDX}}
{{Abdominal Pain DDX Diffuse}}

==Evaluation==
*Assess hydration status
**Cap refill, skin turgor, respiratory rate
*Consider stool labs if:
**>10 stools in previous 24hr
**[[Traveler's diarrhea|Travel to high-risk country]]
**Fever
**Bloody stool
**Persistent diarrhea
**HIV / immunosuppressed

==Management==
#Rehydration (PO preferred)
#*30mL(1oz)/kg/hr
#Antiemetic
#*[[Ondansetron]] 0.15mg/kg/dose IV/PO

===[[Antibiotics]]===
*''Only consider in patients with invasive infection''
**[[Shigella]], [[campylobacter]], [[E. coli]], [[yersinia]], [[vibrio]]
**Bloody stool with mucus and fever
*NOT indicated for [[E. coli]] O157:H7
*NOT routinely indicated for salmonella
**Exceptions: SCD, [[IBD]], <3mo
*[[Azithromycin]] (able to tolerate PO)
*'''OR''' [[ciprofloxacin]]
*'''OR''' [[TMP-SMX]]
*[[Ceftriaxone]] (parenteral)

==Disposition==
*Most can be discharged

===Admit===
*Unable to tolerate PO
*Hemodynamic instability
*Significant comorbidities

==See Also==
*[[Nausea and vomiting]]
*[[Acute gastroenteritis (peds)]]
*[[Dehydration]]
*[[Acute diarrhea]]

==References==
<references/>

[[Category:GI]]