0521779407-08 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:47
Gastroenteritis 609■eating suspect food
➣shellfish, fried rice, unrefrigerated milk or meat, undercooked
poultry or eggs, fermented canned food, imported food
➣eating food at events where others also became ill
■recent antibiotic use
Signs & Symptoms
■nausea, vomiting
■crampy abdominal pain
■diarrhea, watery to dysentery
■headache, fever, myalgia to varying degrees
■symptoms usually last 1–4 days
tests
■start with stool for culture and O&P in select patients:
➣extremes of age
➣immunocompromised host
➣involved in outbreak (including institutional)
➣invasive infection suspected
➣hyposplenism (invasive salmonellosis)
differential diagnosis
■viruses (most common)
➣Norwalk and related caliciviruses
➣rotavirus (especially in young children)
➣astrovirus
➣enteric adenovirus
■bacteria
➣agents listed in food poisoning and infectious diarrhea chapters
■microbial and other toxins
➣listed in food poisoning chapter
■other agents
➣G. lamblia, Cryptosporidium, I. belli
➣alcohol
➣heavy metals
■other conditions
➣eosinophilic gastroenteritis
➣IBD
management
What to Do First
■assess hydration status and administer fluids as appropriate
■obtain samples for further testing from high risk patients or those
involved in outbreaks