View source for Differential diagnosis of diarrheal diseases

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'''Differential diagnosis of diarrhea''' is based on anamnestic data and basic objective examination. If the patient does not report a recent stay in tropical or subtropical areas, we can consider one of the '''4 groups of diseases''' ([[enterotoxicosis]]; acute infectious [[diarrhea]]; conditions mimicking acute infectious diarrhea; subacute, chronic, or recurrent diarrhea).
==Enterotoxicosis==
They are formed after the ingestion of foods containing '''bacterial toxins'''. The stool is watery, yellow, without mucus and blood. The predominant symptom is [[vomiting]]. They have a short incubation period, the initial course is very turbulent, but the disease quickly subsides. '''The treatment '''consists of intensive rapid [[rehydration]].

The most common agents include ''[[Staphylococcus aureus]], [[Bacillus cereus]] a [[Clostridium perfringens]]''.

==Acute infectious diarrhea in the strict sense==
Their cause is the overgrowth of pathogenic microorganisms in the [[intestines]]. The main symptoms include [[fever]] and [[abdominal pain]]. A [[mixture of blood]] and mucus appears in the stool. If the disease is of '''bacterial origin''', vomiting occurs rarely or not at all, but stool is more often mixed with mucus and blood. On the contrary, diarrhea of '''viral origin''' is accompanied by vomiting, the stool is watery. The disease usually lasts for several days.

The treatment is rehydration again. Based on the culture [[examination of the stool]] the etiological agent is determined, which further determines the need for isolation or the use of antibiotics.

*Bacterial etiology: ''[[Salmonela|Salmonella enterica]], [[Campylobacter jejuni]], [[Shigella|Shigella species,]] [[Yersinia enterocolitica]], [[Escherichia coli|Enterotoxické E. coli]], [[Clostridium difficile]]''.
*Viral etiology: [[rotaviruses]], noroviruses, enteroadenoviruses.

==Conditions mimicking acute infectious diarrhea==
====Inflammatory bowel diseases of unknown etiology====
''See [[Crohn's disease]] for more information.''

''See [[Ulcerative Colitis]] for more information.''

The main representatives are ulcerative colitis and Crohn's disease. These diseases are accompanied by fever, diarrhea with mucus, and blood. In the laboratory, we find an increase in [[inflammatory parameters]]. The data of repeated attacks in the past is important.

====Severe disease with a cause outside the digestive tract====
[[File:Ectopic Pregnancy.png|right|thumb|Ectopic pregnancy scheme. Normal pregnancy (left), ectopic pregnancy (right)|300px]]

*[[Sudden abdominal event]] – the main symptom is abdominal pain, subileous to [[Differencial diagnosis of ileal states|ileotic condition]].
*[[Ectopic pregnancy]] is a severe condition accompanied by pallor, weakness, and [[hypotension]]. There is a history of menstrual failure.
*Severe [[sepsis]] – an example is a diarrhea at the onset of meningococcal sepsis.
*Toxic shock syndrome is accompanied by diarrhea, fever, [[rash]], and hypotension.
*[[Legionellosis]] is a disease with major symptoms such as diarrhea, [[pneumonia|pneumonia,]] or [[encephalopathy]].

==Subacute, chronic, or recurrent diarrhea==
The longer the disease lasts, the higher the probability of non-infectious etiology. Of '''inflammatory diseases''' (i.e. with an increase in inflammatory markers) can be Crohn's disease or ulcerative colitis. The reasons are also other serious, '''noninflammatory disorders''', e.g. [[irritable bowel syndrome]], [[rectal cancer]], [[colonic polyps]], conditions after bowel resection syndrome blind loop, [[chronic pancreatitis]], intolerance to certain food components (lactose), [[malabsorption syndromes]] or endocrine disorders ([[hyperthyroidism]], [[diabetes mellitus]]).

'''Infectious diseases''' are also the '''cause''', especially opportunistic infections - clostridial colitis, parasitic infections, [[HIV]]/[[AIDS]].

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==References ==
===Related Articles===

*[[Antidiaroics]]

===References===

* {{Cite
| type = book
| isbn = 978-80-7262-644-1
| surname1 = Beneš
| name1 = Jiří
| collectiv = ano
| title = Infekční lékařství
| edition = 1
| place = Praha
| publisher = Galén
| year = 2009
| area = 475 – 477
}}
{| class="wikitable"
|+
!
{| class="wikitable"
! colspan="2" |Intestinal infections
|-
|In general
|Differential diagnosis of diarrheal diseases • [[Enterotoxicosis]] • [[Diarrheal diseases in childhood]] • [[Drug-induced diarrhea]] • [[Therapy of diarrheal diseases]]
|-
|[[Bacterial]]
|[[Alimentary poisoning ''B. cereus]]'' •'' [[Typhoid fever]] • [[Clostridial colitis]] • [[Cholera]] • [[E. coli colitis]] • [[Infection with non-cholera vibrations]] • [[Campylobacter enteritis]] •
[[Paratyphous]] • [[Salmonella enteritis]] • [[Shigellosis]] • [[Staphylococcal enterotoxicosis]] • [[Yersiniosis]]
|-
|[[Viral]]
|[[Adenovirus enteritis]] • [[Coronavirus enteritis]] • [[Norovirus enteritis]] • [[Rotavirus enteritis]]
|-
|[[Parasitic]]
|[[Amoebiasis]] • [[Ascariasis]] • [[Enterobiosis]] • [[Giardiasis]] • [[Hymenolepiosis]] • [[Cryptosporidiosis]] • [[Teniosis]] • [[Toxoplasmosis]] • [[Trichinellosis]] • [[Trichuriosis]]
|-
| colspan="2" |[[Portal: Infectious Medicine]]
|}
|}
</noinclude>

[[Category:Infectious medicine]]
[[Category:Microbiology]]
[[Category:Gastroenterology]]
[[Category:Hygiene]]
[[Category:Epidemiology]]
[[Category:Differential diagnosis]]