Acute gastroenteritis/es: Difference between revisions
Ostermayer (talk | contribs) (Created page with "gastroenteritis aguda (pediátrica).''") |
Ostermayer (talk | contribs) (Created page with "*La diarrea con sangre sugiere etiología bacteriana *La gastroenteritis aguda viral (AGE) por lo general dura <7 días *No diagnosticar el vómito aislado como gastroenteritis aguda (AGE)") |
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{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|+ | |+ Gastroenteritis aguda invasiva | ||
|- | |- | ||
! scope="col" | ''' | ! scope="col" | '''Especie''' | ||
! scope="col" | ''' | ! scope="col" | '''Inicio''' | ||
! scope="col" | ''' | ! scope="col" | '''Síntomas''' | ||
! scope="col" | ''' | ! scope="col" | '''Transmisión''' | ||
|- | |- | ||
| [[Special:MyLanguage/Salmonella|Salmonella]]||6-72 | | [[Special:MyLanguage/Salmonella|Salmonella]]||6-72 horas|| | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Fiebre|Fiebre]], bradicardia relativa | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Dolor abdominal|Dolor abdominal]] | ||
* | *Diarrea con sangre | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Cefalea|Cefalea]] | ||
* | *Osteomielitis en anemia falciforme | ||
|| | || | ||
* | *Huevos | ||
* | *Avícola | ||
* | *Agua | ||
*Reptiles | *Reptiles | ||
|- | |- | ||
| [[Special:MyLanguage/Shigella|Shigella]]||1-3 | | [[Special:MyLanguage/Shigella|Shigella]]||1-3 días|| | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Fiebre|Fiebre]] | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Dolor abdominal|Dolor abdominal]] | ||
* | *Diarrea con sangre | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Cefalea|Cefalea]] | ||
*1-5 | *1-5 años de edad | ||
* | *Convulsiones en niños | ||
|| | || | ||
* | *Alimentos | ||
*Fecal- | *Fecal-oral | ||
|- | |- | ||
| [[Special:MyLanguage/Yersinia|Yersinia]]||1-5 | | [[Special:MyLanguage/Yersinia|Yersinia]]||1-5 días|| | ||
*[[Special:MyLanguage/ | *Imitación de [[Special:MyLanguage/Apendicitis|apendicitis]], [[Special:MyLanguage/Dolor en el cuadrante inferior derecho|dolor en el cuadrante inferior derecho]] | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Fiebre|Fiebre]] | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Vómitos|Vómitos]] | ||
* | *Niños y jóvenes adultos | ||
|| | || | ||
* | *Agua | ||
* | *Leche | ||
* | *Cerdo | ||
* | *Animales silvestres | ||
*Fecal- | *Fecal-oral | ||
|- | |- | ||
| [[Special:MyLanguage/Campylobacter|Campylobacter]]||1-7 | | [[Special:MyLanguage/Campylobacter|Campylobacter]]||1-7 días|| | ||
* | *Fiebre de bajo grado | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Dolor abdominal|Dolor abdominal]] | ||
* | *Niños y jóvenes adultos | ||
*Guillain- | *Enfermedad de Guillain-Barré | ||
|| | || | ||
* | *Agua | ||
* | *Avícola | ||
* | *Mascotas/animales | ||
|- | |- | ||
| [[Special:MyLanguage/C. Diff|C. Diff]]||1-11 | | [[Special:MyLanguage/C. Diff|C. Diff]]||1-11 semanas|| | ||
* | *Diarrea copiosa y fétida | ||
|| | || | ||
* | *Uso de antibióticos: [[Special:MyLanguage/PCN|PCN]], [[Special:MyLanguage/Clinda|Clinda]], [[Special:MyLanguage/Cefalosporinas|Cefalosporinas]] | ||
|- | |- | ||
| [[Special:MyLanguage/Entamoeba|Entamoeba]]||1-11 | | [[Special:MyLanguage/Entamoeba|Entamoeba]]||1-11 semanas|| | ||
*[[Special:MyLanguage/ | *Imitación de [[Special:MyLanguage/Apendicitis|apendicitis]] | ||
*[[Special:MyLanguage/ | *[[Special:MyLanguage/Dolor abdominal|Dolor abdominal]], [[Special:MyLanguage/náuseas y vómitos|náuseas y vómitos]], [[Special:MyLanguage/diarrea|diarrea]] | ||
|| | || | ||
* | *Agua | ||
* | *Sanidad | ||
* | *Viajes | ||
|} | |} | ||
==Características clínicas== | |||
= | |||
<div lang="en" dir="ltr" class="mw-content-ltr"> | <div lang="en" dir="ltr" class="mw-content-ltr"> | ||
Revision as of 23:22, 12 January 2026
This page is for adult patients. For pediatric patients, see:
gastroenteritis aguda (pediátrica).
Antecedentes
- La diarrea con sangre sugiere etiología bacteriana
- La gastroenteritis aguda viral (AGE) por lo general dura <7 días
- No diagnosticar el vómito aislado como gastroenteritis aguda (AGE)
Causas
| Especie | Inicio | Síntomas | Transmisión | Toxina preformada |
|---|---|---|---|---|
| Viral (norovirus, adenovirus, rotavirus) | 11-72 hrs |
|
|
No |
| Staph | 1-6 hrs |
|
|
Sí |
| B. cereus | 1-6 hrs |
|
|
Sí |
| C. perfringens | 8-24 hrs |
|
|
Sí |
| V. cholerae | 11-72 hrs |
|
|
Sí |
| Giardia | 1-4 semanas |
|
|
No |
| Especie | Inicio | Síntomas | Transmisión |
|---|---|---|---|
| Salmonella | 6-72 horas |
|
|
| Shigella | 1-3 días |
|
|
| Yersinia | 1-5 días |
|
|
| Campylobacter | 1-7 días |
|
|
| C. Diff | 1-11 semanas |
|
|
| Entamoeba | 1-11 semanas |
|
|
Características clínicas
- 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
- 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
