Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The value of faecal leucocyte examination was assessed in 400 infants with acute diarrhoea and 40 normal healthy infants. Enteropathogens were isolated from 28.75%. Escherichia coli was the commonest (16.5%) followed by Salmonella typhimurium (7%), Vibrio cholerae (3.25%) and Shigella flexneri (1.5%). Exudative response was observed in 57.1% of stools with Salmonella and 66.6% each with Shigella and E.I.E.C. infections. 81.3%, 89.5% and 87.7% of stools from which EPEC and ETEC and no enteropathogens respectively were isolated showed minimal or no Leucocytic response. The test is useful to recognise probable invasive bacterial diarrhoea and to decide the cases in which stool culture could be advantageous.
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PMID:Role of faecal leucocytes in the diagnostic evaluation of acute diarrhoea. 179 52

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

Empiric treatment with ciprofloxacin and norfloxacin has been recommended recently for patients with acute diarrhoeal disease. In a retrospective 6-month study period the results of stool cultures from 209 patients with acute diarrhoea admitted to the emergency room were analysed. Seventy-eight cultures (37%) were positive for one or more bacteria. Shigella was the most commonly isolated pathogen (68%). Shigella sonnei comprised 72% and Shigella flexneri 19% of all the bacterial isolates. While no antimicrobial resistance to ciprofloxacin was found for both Shigella species, only 36 and 26% of the Shigella isolates were sensitive to ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ), respectively. These findings point out to the emergence of drug resistance to commonly used antimicrobial drugs. Shigella's high sensitivity to the newer quinolones should make this the treatment of choice for the very sick patient, although physicians should be cautioned to the fact that indiscriminate use of this drug could result in the emergence of resistance similar to that noted with ampicillin and TMP-SMZ.
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PMID:Acute bacterial diarrhoea in the emergency room: therapeutic implications of stool culture results. 780 82

A total of 106 children below 5 years of age admitted to the Kasturba Medical College Hospital Manipal Karnataka (South India) were investigated over a period of 6 months to determine the aetiological role of viruses in acute diarrhoea. Viral aetiological agents isolated were Rotaviruses in 12 (11 per cent) cases, Adenoviruses in 3 (3 per cent) cases, coronavirus and astroviruses in two (2 per cent) cases each. Non-viral isolates were Cryptosporidium and Salmonella typhimurium in two cases each, and Entamoeba histolytica and Shigella flexneri in one case each.
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PMID:Viral diarrhoea in a rural coastal region of Karnataka India. 853 Dec 64

Stool samples of 1488 children suffering from acute diarrhoea were studied for bacterial culture and sensitivity. Shigella culture was positive in 143 (10 per cent) children and 53 hospitalized children could be studied in detail. Thirty-six (68 per cent) children were under 2 years of age and peak prevalence was observed in summer months. Fever and diarrhoea were universal features; 96 per cent had blood and mucus in the stools, but 32 per cent started with watery diarrhoea lasting 1-3 days followed by dysentery. Two cases (4 per cent) had watery diarrhoea. Abdominal pain dehydration, and malnutrition were present in more than two-thirds of the cases. Central nervous systemic (CNS) manifestations, renal failure, respiratory manifestations, and subacute intestinal obstruction were seen in 45, 25, 17, and 5 per cent of cases, respectively. Shigella dysenteriae was the commonest organism grown in 57 per cent, followed by Shigella flexneri in 36 per cent, Shigella boydii in 4 per cent, and Shigella sonnei in 4 per cent cases. In the majority, the organisms were sensitive to neomycin (83 per cent), furazolidine (86 per cent), and cephaloridine (87 per cent), whereas Shigella strains were resistant to tetracycline in 93 per cent, ampicillin in 83 per cent, chloramphenicol in 91 per cent and cotrimoxazole in 66 per cent cases. Proctosigmoidoscopy was useful in defining the nature of mucosal lesion, to collect swabs for culture and biopsy specimen for histopathology. Four (8 per cent) cases had pseudomembrane and in two cases Clostridium difficile could be identified. Eight (15 per cent) cases died and two of them had shigellaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Shigellosis in children from north India: a clinicopathological study. 853 Dec 65

Food borne disease outbreaks have increased in France, but outbreaks caused by Shigella are rare, accounting for only 73 cases (1.62%) in 1993. We report a food borne outbreak of Shigella flexneri strain 3 infection in a fire fighting unit in Paris between July 13th and 17th 1995. Forty of the 127 firemen suffered symptoms including acute diarrhea (80%), fever (50%) and blood and mucus in stools (1 case, 2.5%). Epidemiological investigation generated an unimodal epidemic curve suggesting a single source of contamination with no secondary cases. The median incubation period was between 43 hours 30 minutes and 51 hours 30 minutes. This is consistent with food borne Shigella infection. Statistical analysis of a case-control study implicated a mixed salad containing frozen shellfish from Asia (shrimps and mussels), served at lunch and dinner on July 13th 1995. Shigella was not detected in this salad by microbiological methods. However, inoculation with as little as 100 organisms can cause symptoms. There was low-level contamination with Escherichia coli (940 cfu/g) due to cross-contamination. Shigella flexneri strain 3 was isolated from 11 of 18 stool cultures, but was never isolated from cultures of stools provided by the cooks. All isolates had identical antibiotic resistance profiles. They were resistant to ampicillin and ticarcillin, moderately sensitive to amoxicillin-clavulanic acid, highly sensitive to aminosides, erythromycin and quinolones. This identical pattern in all isolates suggests a common source of contamination. Plasmid-based multiple resistance is common in this organism. Therefore, antibiotics should only be given to patients with evident clinical signs of infection. Treatment was symptom-based in all but 4 patients, who had acute diarrhea and were treated with ciprofloxacin. This antibiotic is well tolerated, has rapid bactericidal action and significantly reduces the duration of the symptoms and excretion of Shigella, thus preventing secondary contamination with this highly infectious bacterium. Thus, food borne outbreaks of Shigella can occur in countries with a high standard of living because of the increase in mass catering (e.g. fast food restaurants) and importation of foodstuffs from developing countries with endemic shigellosis. This is a public health problem because of the morbidity and absenteeism due to illness, particularly when the patients are firemen responsible for emergency management.
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PMID:[Toxic food infection caused by Shigella flexneri in a military unit]. 948 34

Persistent diarrhea very often leads children to malnutrition. It has become the major cause of death resulting from acute diarrhea episodes in developing countries. In order to determine the ultrastructural alterations of the small bowel that occur in the syndrome, 16 infants with severe persistent diarrhea were studied, utilizing light microscopy and the scanning electron microscope. Stool and jejunal fluid samples were collected for culture, rotavirus, ova and parasite search. Enteropathogenic agents were isolated in stools from 11 (68.7%) patients and bacterial proliferation in the small bowel was detected in 11 (68.7%) patients. EPEC strains were the most frequent enteropathogenic agent isolated both from stool and jejunal fluid cultures. The stool cultures revealed the presence of the following enteropathogenic microorganisms: EPEC 0111 in four, EPEC 0119 in one, EAggEC in five, Shigella flexneri in two, and Shigella sonnei in one; mixed infections due to EAggEC associated with EPEC 0111 were seen in two patients. The light microscopic analysis revealed that 56.2% of the patients suffered moderate villous atrophy most frequently associated with effacement of the microvilli, intracytoplasmatic vacuolization, increased number of multivesicular bodied and increased lymphocytic and eosinophylic infiltration in the lamina propria. The scanning electron microscopic analysis revealed in all cases shortening of the villi and enterocyte derangements; very often there was a total lack and/or effacement of the microvilli; in half of the patients there was a mucoid material covering the enterocytes tightly adhered to the apical epithelium surface. The scanning ultrastructural alterations observed in these patients are probably due to an association of factors brought about by the presence of enteropathogenic microorganisms and the resulting food intolerance that is responsible for perpetuation of diarrhea.
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PMID:[Scanning electronic microscopy of the small intestine in persistent diarrhea]. 949 27

Between July 1996 to June 1997 a total of 531 Stool samples from cases of acute diarrhoea, dysentry, colitis admitted to Kasturba Medical College Hospital, Manipal were investigated. Shigella were isolated from 29 samples (5.46%). Out of them, Shigella flexneri were 16 (55.17%), Shigella boydii 8 (27.58%), Shigella dysentriae 3 (10.34%) and Shigella sonnei 2 (6.89%). Five strains of Shigella flexneri and one strain of Shigella dysentriae were found to show resistance to Nalidixic acid and the newer fluoroquinolones viz., Ciprofloxacin, Norfloxacin and Ofloxacin. The in vitro 'R' factor transfer study showed that the resistance was not transferable.
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PMID:Shigella and the fluorinated quinolones. 986 7

An investigation on the prevalence of Aeromonas in gastrointestinal illnesses of pediatric inpatients 1 month to 3 years of age was conducted from February 1997 through January 1998 in Madras. Sixteen Aeromonas spp. were isolated from 11 male and five female children among the 341 pediatric inpatients suffering from acute diarrhoea. A. caviae, which was isolated from nine cases, was found to be the most predominant isolate, followed by A. veronii biovar sobria, isolated from six cases, and A. hydrophila, isolated from one case. Shigella flexneri was recovered along with Aeromonas veronii biotype sobria serotype 035 from one 5-month-old female child. We did not notice any seasonal pattern in the association between Aeromonas and childhood gastroenteritis. None of the 147 stool samples obtained from age-matched non-diarrhoeic control children yielded Aeromonas spp. Isolation of Aeromonas spp. from patients suffering from gastroenteritis was found to be significant (chi 2 = 7.1312; P = 0.008, < 0.01). Among the 16 Aeromonas isolates, seven isolates of A. caviae and two isolates of A. veronii biovar sobria induced a secretory response in rabbit intestinal mucosa mounted in Ussing chambers as demonstrated by a significant increase in the short circuit current. Nine of the 16 Aeromonas isolates, including three isolates of A. caviae, five isolates of A. veronii biovar sobria, and the solitary isolate of A. hydrophila were also cytotoxic to CHO cells. Five of the six isolates of A. veronii biovar sobria and the A. hydrophila isolate produced hemolysin. The results of this study indicate that Aeromonas species are important causative agents of diarrhoea in childhood gastroenteritis and are prevalent throughout the year in Madras.
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PMID:Prevalence, in-vitro secretory activity, and cytotoxicity of Aeromonas species associated with childhood gastroenteritis in Chennai (Madras), India. 1021 27

The prevalence of viral, bacterial and parasitic pathogens among children of Jeddah, Saudi Arabia, was investigated. During December 1995-October 1996, 576 faecal samples were collected from children (0-5 year(s) old) suffering from acute diarrhoea and attending hospitals and outpatient clinics in Jeddah. One or more enteropathogen(s) were identified in 45.6% of the stool specimens. Mixed infections were detected in 12.2% of the diarrhoeal cases. Rotavirus was detected in 34.6% of the specimens of the hospitalized patients and in 5.9% of the specimens of the outpatients. Fifty-one percent of the rotavirus-positive specimens were long electropherotype, 26% were short electropherotype, and 23% could not be electropherotyped specifically. Among those of the long electropherotype, there were six patterns; and of the short electropherotypes, there were four patterns. Serotyping of these specimens revealed a distribution of 39.6%, 4.2%, 6.3%, and 15.6% for rotavirus serotype 1, 2, 3, and 4 respectively. Mixed serotypes were found in 3.1%, and 31.3% of the specimens were untypeable. Other aetiologic agents recognized included Escherichia coli (13%), of which 3.8% were enteropathogenic E. coli (EPEC) and 1.9% enterohaemorrhagic E. coli. Among the E. coli (EPEC) serotypes, O111:K58:B4, O55:K59:B11, and 0127:K63:B8 were found in 31.8%, 18.2%, and 13.6% of the cases respectively. Serotype 026:K60:B6, 0124:K72:B17, and 0112:K66:B11 each was found in 9.1% of the EPEC cases. 0128:K67:B12 and 0125:K70:B13 each was found in one case only. Other detected pathogens were: Klebsiella pneumoniae (4%), Giardia lamblia (3.1%), Salmonella sp. (3%), Shigella flexneri (2.6%), Entamoeba histolytica (2.2%), Trichuris trichiura, Hymenolepis nana, and Ascaris lumbricoides (0.7% each), and Candida albicans (0.5%). Based on the results of this study, it is concluded that the high prevalence of the various enteropathogens among young children is a significant public health problem.
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PMID:Prevalence of viral, bacterial and parasitic enteropathogens among young children with acute diarrhoea in Jeddah, Saudi Arabia. 1139 80


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