- Protozoa causing diarrhea.
- Oocysts are 4-6 µm in diameter and exhibit partial acid-fast staining.
- Mostly commonly seen in HIV+
- Most common cause of chronic diarrhea in HIV patients.
- Swim regularly in pools with insufficient sanitation.
- Hikers who drink untreated water.
- Handling infected cattle.
Symptoms usually appear one week after infection which include:
- Stomach cramps/pain
- Watery diarrhea
- Weight loss
- Viral (e.g. rotavirus)
- GI Bleed
- Mesenteric Ischemia
- Adrenal Crisis
- Thyroid Storm
- Toxicologic exposures
- Antibiotic or drug-associated
- Enterotoxigenic E. coli (most common cause of watery diarrhea)
- Norovirus (often has prominent vomiting)
- Non-typhoidal Salmonella
- Enteroaggregative E. coli (EAEC)
- Enterotoxigenic Bacteroides fragilis
- Stool acid-staining test
- Stool Culture
- If patient non-sick appearing and not immunocompromised, medication often not needed
- Antiparasitics such as nitazoxanide for immunocompromised patients
- IV/PO hydration if dehydration present
- If patient not on HAART therapy, consider contacting HIV/ID for initiating therapies
- Most of these patient's can be discharged with close PMD/HIV follow up.
- If patient has electrolyte abnormalities or severely dehydrated consider observation placement vs admission for rehydration therapy
- Marx et al. “Cholera and Gastroenteritis caused by Noncholera Vibrio Species”. Rosen’s Emergency Medicine 8th edition vol 1 pg 1245-1246.