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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Bacterial, viral and parasitic enteric pathogens were detected in 692 of 916 children below 36 months of age with acute diarrhoea and in 289 of 587 matched controls. The rates of identification of only four groups of pathogens, rotavirus, Shigellae, Salmonella typhimurium and enterotoxigenic E. coli, were significantly higher in the patients. The prevalence of a variety of other enteric pathogens was similar in controls of patients. Shigellosis had a characteristic clinical profile but none of the other agents could be suspected on clinical grounds. The high prevalence of pathogens in controls suggested that the population may be partially protected against a variety of enteric pathogens and that final common pathways leading to diarrhoea may be activated by changes in the microbial ecology of the gut lumen.
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PMID:The relationship of microbial pathogens to acute infectious diarrhoea of childhood. 188 Aug 28

Acute gastroenteritis is the commonest gastrointestinal disorder in children. It accounted for about 10% of the admissions to a general paediatric unit in Singapore. About 5% of total paediatric admissions to all the government hospitals in Singapore were due to acute gastroenteritis. Some 50% of the cases had no identifiable organism in the stools. Most of the remaining cases were due to bacterial or viral infections. The commonest bacteria responsible for acute gastroenteritis nowadays is Salmonella species. Other bacteria such as E. coli, Shigella and Campylobacter were responsible for a smaller proportion of bacterial diarrhoea in children. Rotavirus was the commonest viral agent responsible for acute diarrhoea among Singapore children. Most patients had mild diarrhoea and severe dehydration following acute gastroenteritis was not common. About 60% of the patients admitted to hospital were younger than two years of age. Bacterial infections were more common in infancy. Viral diarrhoea were more likely to be watery and bacterial diarrhoea were more likely to be bloody and mucoid. With regard to chronicity, it was the groups with mixed infection or bacteria infection which had a prolonged course. Treatment was directed at maintaining hydration and prevention of complications. Except for secondary lactase deficiency, other long term complications were rare.
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PMID:Gastrointestinal infections in Singapore children. 188 88

A study was conducted of travelers' diarrhea in a United States military population on deployment in Cairo, Egypt, during July and August 1987. Acute diarrhea requiring medical attention developed in 183 (4%) of 4,500 troops. A possible etiologic agent was identified in 49% of all diarrhea cases. Enteric pathogens associated with cases of diarrhea included: Enterotoxigenic Escherichia coli (17% ST-producers, 13% LT-producers, and 3% LT/ST-producers); Shigella (9%); Campylobacter spp. (2%); Salmonella (2%); and Vibrio cholerae non-01 serogroup (2%). Other enteric pathogens isolated from one episode each of diarrhea included Aeromonas hydrophila group, Plesiomonas shigelloides, and Bacillus cereus. Yersinia enterocolitica, enteroinvasive E. coli, intoxications by Clostridium perfringens and Clostridium difficile, and pathogenic enteric parasites were not found in any of the 183 patients with diarrhea. A survey of military personnel not requesting medical care indicated that up to 40% of troops may have had diarrhea during this deployment. Acute gastroenteritis is a potential cause of substantial morbidity in U.S. military personnel deployed to Egypt.
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PMID:Travelers' diarrhea among United States military personnel during joint American-Egyptian armed forces exercises in Cairo, Egypt. 190 Jan 13

Researchers compared data on acute diarrhea incidence with data on rainfall and temperature of 10 provinces and 15 districts of Khon Kaen province in northeast Thailand to determine the link between seasonal weather patterns and reported incidence of acute diarrhea. The relative incidence of diarrhea decreased with age in the winter while it increased with age in the hot season and early in the rainy season. Indeed reported incidence of diarrhea peaked in January for children 2 years old. The researchers suggested that rotavirus was the leading causative agent in this age group since it is common in cooler months and in children 2 years old. Another peak occurred in April-June when temperatures are high and early in the rainy season. This peak involved mainly adults. The researchers believed enterotoxigenic Escherichia coli, Campylobacter jejuni, and Shigella were the leading causative agents. The researchers posed a possible explanation for this April-June peak. In the beginning of the wet season, households changed their water source from groundwater to rainwater and began to use it differently. Further, they often stored water separately from rainjars. It was more likely that this water was more contaminated than stored rainwater or groundwater. In addition, fecal bacteria transmitted by food preparation and utensil handling and the rising humidity fostered its growth. These events may have accounted for the increased incidence of diarrhea in the early rainy season. A steep reduction in diarrhea incidence occurred around the middle of the wet season (July and August). Research has shown that increased water quantity may be better in reducing diarrhea incidence than only improving water quality. Furthermore, it also demonstrated that bacteriological quality of water stored in rainjars was better than water from shallow wells.
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PMID:Seasonal effects on the reported incidence of acute diarrhoeal disease in northeast Thailand. 195 64

Shigella species have been one of the most common causes of acute diarrhea in Bangkok, Thailand. The incidence of shigellosis increased steadily from 1984 to 1988. The majority of Shigella species isolated from specimens from patients with acute diarrhea in Bangkok in 1988 were resistant to both ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ). Shigella flexneri was the most commonly isolated organism and had the highest rate of resistance to ampicillin, chloramphenicol, TMP-SMZ, and tetracycline. The antimicrobial agents of choice for the treatment of shigellosis have been changed from ampicillin to TMP-SMZ and recently to the fluoroquinolones. We conducted a controlled study of norfloxacin that revealed its efficacy for eradication of Shigella species from the stool of both adults and children. The fluoroquinolones shorten the course of diarrhea, reduce the shedding of the organism, and prevent the spread of infection. No short-term adverse effects of the quinolones were observed in this study; however, its use among children should be restricted to treatment of severe shigellosis and the duration of treatment should be as short as possible.
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PMID:Response to antimicrobial therapy for shigellosis in Thailand. 204 60

The effect of antibiotic therapy on intake of food and absorption of nutrients for 19 male children aged 1-5 years with suspected shigella infection was studied. The children were admitted to the hospital with acute diarrhea, high fever, abdominal pain, and greater than or equal to 25 red blood cells and white blood cells per high-power field in the stool. Microbiologic diagnosis was made within 48 hours of admission. On the basis of clinical and microbiologic criteria, children were classified as having mild or severe infection. Ten children with mild infection did not receive antibiotics, whereas nine children with severe infection were treated with ampicillin. After the children were rehydrated, a 72-hour balance study was carried out during the acute stage of infection with Shigella and was repeated 2 weeks after recovery. The levels of consumption of food and absorption of nutrients were estimated. During the acute stage of infection, such levels were higher for the children treated with antibiotics than for the untreated group. During the recovery phase, the levels of intake of food and absorption of nutrients were equal for both groups. Thus, children who are treated with appropriate antibiotics not only may recover from infection with Shigella more rapidly, but they also may be able to absorb nutrients more efficiently.
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PMID:Effect of antibiotics on food intake and absorption of nutrients for children with diarrhea due to Shigella. 204 61

Before 1970, laboratory staff could not only identify the causative organism of acute diarrhea in 20% of cases, but in 1990, they could identify it in 80% of cases. These organisms are either bacteria, virus, or parasites. The bacteria include enterotoxigenic bacteria (Vibrio cholerae, enterotoxigenic Escherichia coli, Clostridium perfringens, and Staphylococcus aureus) and enteroinvasive bacteria (Campylobacter jejuni, C. coli, and Salmonella and Shigella species). The leading cause of death in diarrhea patients is dehydration. Oral rehydration solutions (ORS) can alleviate mild and moderate dehydration regardless of the etiology of the diarrhea or the age of the patient. WHO recommends an ORS containing glucose and various electrolytes which permit salt and water absorption in many cases of acute diarrhea. Due to the possibility of excess salt entering the bloodstream (hypernatremia), some pediatricians do not use the WHO recommended ORS in newborns and young infants. Instead they use 2 parts ORS followed by 1 part water. This treatment is not easy for illiterate mothers to follow, however. Continued breast feeding during diarrheal episodes along with administration of ORS protects not only against dehydration, but also hypernatremia. ORS should not be administered in severe case of dehydration, however. Medical personnel need to administer replacement fluid such as Ringer's Lactate solution intravenously regardless of the age group. Once the initial deficit has been controlled, ORS administration and reintroduction of foods can follow. Antibiotics should only be administered if the medical personnel suspect severe cholera in an endemic area (tetracycline and furazolidone); shigellosis, but 1st the bacteria must be tested to see if the strain is multiple drug resistant (ampicillin, trimethoprim-sulphamethoxazole, furazolidone, nalidixic acid), and acute amebiasis or giardiasis (metronidazole and tinidazole). Antidiarrheals should not be used.
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PMID:Management of acute diarrhoea. 210 85

From June 1985 to September 1987, 202 adults were enrolled in a randomized, double-blinded study comparing ciprofloxacin (500 mg) with sulfamethoxazole and trimethoprim (160 mg/800 mg) or placebo for adults with acute diarrhea. All patients were treated on the day of presentation and received medication on a twice-daily schedule (every 12 hours) for 5 days. Bacterial isolates from these patients included 35 Campylobacter, 18 Shigella, and 15 Salmonella. Treatment at the time of presentation with ciprofloxacin compared with placebo shortened the duration of diarrhea (2.4 vs 3.4 days), and increased the percentage of patients cured or improved by treatment days 1, 3, 4, and 5. Similar significant differences for sulfamethoxazole and trimethoprim compared with placebo were not seen.
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PMID:Empiric antimicrobial therapy of domestically acquired acute diarrhea in urban adults. 172 22

Andrographis paniculata (Burma) Wall. ex Ness (AP) is a herbal medicine and has been used for therapy of upper respiratory tract infection (URI) as well as acute diarrhea with reported efficacy of 75-100 per cent. To investigate whether anti-bacterial activity was responsible for the reported therapeutic success of AP, we carried out a number of studies. The first study was a direct assay of anti-bacterial activity of AP suspended in water. The tested pathogens included Salmonella, Shigella, E.coli, gr. A Streptococci and S.aureus. Anti-bacterial activity was not demonstrable even in a solution containing 25,000 mg per litre of crude powder. The second was designed to detect serum bactericidal activity after oral intake of stem and leaves of AP. Ten healthy volunteers were enrolled in the study. They received a single oral dose of AP (1, 2, 3 and 6 g) in a randomized, cross-over manner. The washout period was one week. Blood samples were taken at 0, 1, 2, 4, 8 and 24 hours after ingestion. Serum bactericidal activity was assayed by agar diffusion technique using Bacillus spores and five strains of each pathogen (Shigella, Salmonella typhi, S.aureus and gr. A Streptococci) incubated for 24 hours. Again serum bactericidal activity was not detected in any of the sera tested. In a third study, ninety-six rats were daily fed with high doses of AP ranging 0.12-24 g per kg body wt. for six months before sacrifice. Antibacterial activity was still undetectable when lung parenchyma and liver tissue was placed on culture media containing bacteria tested. In conclusion, anti-bacterial activity of AP is undetectable in our study.
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PMID:Undetectable anti-bacterial activity of Andrographis paniculata (Burma) wall. ex ness. 223 Jun 23

The aetiology of acute diarrhoea was investigated in 245 children less than 3 years old in a paediatric outpatient clinic in southern India. In 55% of the children organisms were found in the stools, and one quarter were infected with multiple organisms. Viruses, enteropathogenic E. coli, shigella and campylobacter species accounted for 75% of all isolates. Cholera and helminthiasis were rare, and no child had amoebiasis. Clinical findings were useful in the diagnosis of shigella and rotavirus infection only. Children with shigellosis had classical dysentery, and a greater number of stools; they were unlikely to be breast-fed, to be less than 6 months old, or to have watery stools. Rotavirus infections were characterized by vomiting. Only 20% of the 245 children had an infection which could be treated effectively with antimicrobials.
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PMID:Aetiology and clinical features of acute childhood diarrhoea in an outpatient clinic in Vellore, India. 244 63


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