Diferencia entre revisiones de «Acute gastroenteritis»
(Prepared the page for translation) |
(Marked this version for translation) |
||
| Línea 3: | Línea 3: | ||
</translate> | </translate> | ||
{{Adult top}} | {{Adult top}} | ||
<translate> [[Special:MyLanguage/acute gastroenteritis (peds)|acute gastroenteritis (peds)]].'' | <translate> <!--T:1--> | ||
[[Special:MyLanguage/acute gastroenteritis (peds)|acute gastroenteritis (peds)]].'' | |||
==Background== | ==Background== <!--T:2--> | ||
<!--T:3--> | |||
*Blood diarrhea suggests bacterial etiology | *Blood diarrhea suggests bacterial etiology | ||
*Viral AGE usually lasts <7d | *Viral AGE usually lasts <7d | ||
| Línea 12: | Línea 14: | ||
===Causes=== | ===Causes=== <!--T:4--> | ||
<!--T:5--> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+ Noninvasive AGE | |+ Noninvasive AGE | ||
| Línea 75: | Línea 78: | ||
|} | |} | ||
<!--T:6--> | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|+ Invasive AGE | |+ Invasive AGE | ||
| Línea 143: | Línea 147: | ||
==Clinical Features== | ==Clinical Features== <!--T:7--> | ||
<!--T:8--> | |||
*[[Special:MyLanguage/Vomiting|Vomiting]]/[[Special:MyLanguage/diarrhea|diarrhea]] | *[[Special:MyLanguage/Vomiting|Vomiting]]/[[Special:MyLanguage/diarrhea|diarrhea]] | ||
*Crampy/diffuse [[Special:MyLanguage/abdominal pain|abdominal pain]] | *Crampy/diffuse [[Special:MyLanguage/abdominal pain|abdominal pain]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== <!--T:9--> | ||
</translate> | </translate> | ||
| Línea 159: | Línea 164: | ||
==Evaluation== | ==Evaluation== <!--T:10--> | ||
<!--T:11--> | |||
*Assess hydration status | *Assess hydration status | ||
**Cap refill, skin turgor, respiratory rate | **Cap refill, skin turgor, respiratory rate | ||
| Línea 172: | Línea 178: | ||
==Management== | ==Management== <!--T:12--> | ||
<!--T:13--> | |||
#Rehydration (PO preferred) | #Rehydration (PO preferred) | ||
#*30mL(1oz)/kg/hr | #*30mL(1oz)/kg/hr | ||
| Línea 180: | Línea 187: | ||
===[[Special:MyLanguage/Antibiotics|Antibiotics]]=== | ===[[Special:MyLanguage/Antibiotics|Antibiotics]]=== <!--T:14--> | ||
<!--T:15--> | |||
*''Only consider in patients with invasive infection'' | *''Only consider in patients with invasive infection'' | ||
**[[Special:MyLanguage/Shigella|Shigella]], [[Special:MyLanguage/campylobacter|campylobacter]], [[Special:MyLanguage/E. coli|E. coli]], [[Special:MyLanguage/yersinia|yersinia]], [[Special:MyLanguage/vibrio|vibrio]] | **[[Special:MyLanguage/Shigella|Shigella]], [[Special:MyLanguage/campylobacter|campylobacter]], [[Special:MyLanguage/E. coli|E. coli]], [[Special:MyLanguage/yersinia|yersinia]], [[Special:MyLanguage/vibrio|vibrio]] | ||
| Línea 194: | Línea 202: | ||
==Disposition== | ==Disposition== <!--T:16--> | ||
<!--T:17--> | |||
*Most can be discharged | *Most can be discharged | ||
===Admit=== | ===Admit=== <!--T:18--> | ||
<!--T:19--> | |||
*Unable to tolerate PO | *Unable to tolerate PO | ||
*Hemodynamic instability | *Hemodynamic instability | ||
| Línea 206: | Línea 216: | ||
==See Also== | ==See Also== <!--T:20--> | ||
<!--T:21--> | |||
*[[Special:MyLanguage/Nausea and vomiting|Nausea and vomiting]] | *[[Special:MyLanguage/Nausea and vomiting|Nausea and vomiting]] | ||
*[[Special:MyLanguage/Acute gastroenteritis (peds)|Acute gastroenteritis (peds)]] | *[[Special:MyLanguage/Acute gastroenteritis (peds)|Acute gastroenteritis (peds)]] | ||
| Línea 214: | Línea 225: | ||
==References== | ==References== <!--T:22--> | ||
<!--T:23--> | |||
<references/> | <references/> | ||
<!--T:24--> | |||
[[Category:GI]] | [[Category:GI]] | ||
</translate> | </translate> | ||
Revisión actual - 16:59 6 ene 2026
This page is for adult patients. For pediatric patients, see:
acute gastroenteritis (peds).
Background
- Blood diarrhea suggests bacterial etiology
- Viral AGE usually lasts <7d
- Do not diagnose isolated vomiting as AGE
Causes
| Species | Onset | Symptoms | Transmission | Preformed Toxin |
|---|---|---|---|---|
| Viral (norovirus, adenovirus, rotavirus) | 11-72 hrs |
|
|
No |
| Staph | 1-6 hrs |
|
|
Yes |
| B. cereus | 1-6 hrs |
|
|
Yes |
| C. perfringens | 8-24 hrs |
|
|
Yes |
| V. cholerae | 11-72 hrs |
|
|
Yes |
| Giardia | 1-4 wks |
|
|
No |
| Species | Onset | Symptoms | Transmission |
|---|---|---|---|
| Salmonella | 6-72 hours |
|
|
| Shigella | 1-3 days |
|
|
| Yersinia | 1-5 days |
|
|
| Campylobacter | 1-7 days |
|
|
| C. Diff | 1-11 Weeks |
|
|
| Entamoeba | 1-11 weeks |
|
Clinical Features
- Vomiting/diarrhea
- Crampy/diffuse abdominal pain
Differential Diagnosis
Nausea and vomiting
Critical
Emergent
- Acute radiation syndrome
- Acute gastric dilation
- Adrenal insufficiency
- Appendicitis
- Bowel obstruction/ileus
- Carbon monoxide poisoning
- Cholecystitis
- CNS tumor
- Electrolyte abnormalities
- Elevated ICP
- Gastric outlet obstruction, gastric volvulus
- Hyperemesis gravidarum
- Medication related
- Pancreatitis
- Peritonitis
- Ruptured viscus
- Testicular torsion/ovarian torsion
Nonemergent
- Acute gastroenteritis
- Biliary colic
- Cannabinoid hyperemesis syndrome
- Chemotherapy
- Cyclic vomiting syndrome
- ETOH
- Gastritis
- Gastroenteritis
- Gastroparesis
- Hepatitis
- Labyrinthitis
- Migraine
- Medication related
- Motion sickness
- Narcotic withdrawal
- Thyroid
- Pregnancy
- Peptic ulcer disease
- Renal colic
- UTI
Diffuse Abdominal pain
- Abdominal aortic aneurysm
- Acute gastroenteritis
- Aortoenteric fisulta
- Appendicitis (early)
- Bowel obstruction
- Bowel perforation
- Diabetic ketoacidosis
- Gastroparesis
- Hernia
- Hypercalcemia
- Inflammatory bowel disease
- Mesenteric ischemia
- Pancreatitis
- Peritonitis
- Sickle cell crisis
- Spontaneous bacterial peritonitis
- Volvulus
Evaluation
- Assess hydration status
- Cap refill, skin turgor, respiratory rate
- Consider stool labs if:
- >10 stools in previous 24hr
- 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
