Difference between revisions of "Diarrhea (peds)"

(Text replacement - "==Treatment==" to "==Management==")
Line 7: Line 7:
 
*Viral  
 
*Viral  
 
**[[Rotavirus]]  
 
**[[Rotavirus]]  
**Norwalk virus  
+
**[[Norovirus]], Norwalk virus  
**Enteroviruses
+
**[[Enterovirus]]
**Adenoviruses  
+
**[[Adenoviruses]]
 
*Bacterial  
 
*Bacterial  
 
**[[Salmonella]]
 
**[[Salmonella]]
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**[[Giardia]]  
 
**[[Giardia]]  
 
**[[Entamoeba]]  
 
**[[Entamoeba]]  
**[[Cryptosporidia]]
+
**[[Cryptosporidium]]
  
 
===Dietary disturbances===
 
===Dietary disturbances===
 
*Overfeeding  
 
*Overfeeding  
*Food allergy  
+
*Food [[allergic reaction|allergy]]
 
*Starvation stools
 
*Starvation stools
  
 
===Anatomic abnormalities===
 
===Anatomic abnormalities===
 
*[[Intussusception]]  
 
*[[Intussusception]]  
*Hirschsprung disease  
+
*[[Hirschsprung's disease]]
*Partial obstruction
+
*Partial [[SBO]]
 
*[[Appendicitis]]  
 
*[[Appendicitis]]  
 
*Blind loop syndrome  
 
*Blind loop syndrome  
 
*Intestinal lymphangiectasia  
 
*Intestinal lymphangiectasia  
*Short bowel syndrome
+
*[[Short bowel syndrome]]
  
 
===Malabsorption or secretory diseases===
 
===Malabsorption or secretory diseases===
*Cystic fibrosis  
+
*[[Cystic fibrosis]]
 
*Celiac disease  
 
*Celiac disease  
 
*Disaccharidase deficiency  
 
*Disaccharidase deficiency  
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*Immunodeficiency  
 
*Immunodeficiency  
 
*Endocrinopathy  
 
*Endocrinopathy  
**Hyperthyroidism  
+
**[[Hyperthyroidism]]
**Hypoparathyroidism  
+
**[[Hypoparathyroidism]]
**Congenital adrenal hyperplasia
+
**[[Congenital adrenal hyperplasia]]
  
 
===Miscellaneous===
 
===Miscellaneous===
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*Secondary lactase deficiency  
 
*Secondary lactase deficiency  
 
*Irritable colon syndrome  
 
*Irritable colon syndrome  
*Neonatal drug withdrawal
+
*[[Neonatal abstinence syndrome]]
 
*[[Toxins]]  
 
*[[Toxins]]  
 
*[[Hemolytic uremic syndrome]]
 
*[[Hemolytic uremic syndrome]]
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==Management==
 
==Management==
 
===General Treatment===
 
===General Treatment===
*If bloody diarrhea, use caution with beginning antibioitics in ED before stool culture results
+
*If bloody diarrhea, use caution with beginning antibiotics in ED before stool culture results
 
*Some studies demonstrate antibiotic treatment in setting of ''[[E.coli]]'' O157:H7 leads to increasing risk of [[hemolytic uremic syndrome]] (HUS)
 
*Some studies demonstrate antibiotic treatment in setting of ''[[E.coli]]'' O157:H7 leads to increasing risk of [[hemolytic uremic syndrome]] (HUS)
  

Revision as of 19:04, 21 August 2019

Background

Clinical Features

Differential Diagnosis

Infection

Dietary disturbances

  • Overfeeding
  • Food allergy
  • Starvation stools

Anatomic abnormalities

Malabsorption or secretory diseases

  • Cystic fibrosis
  • Celiac disease
  • Disaccharidase deficiency
  • Secretory neoplasms

Systemic diseases

Miscellaneous

Evaluation

Management

General Treatment

  • If bloody diarrhea, use caution with beginning antibiotics in ED before stool culture results
  • Some studies demonstrate antibiotic treatment in setting of E.coli O157:H7 leads to increasing risk of hemolytic uremic syndrome (HUS)

Diarrheal Pathogens in Children and Specific Therapy

AGENT SPECIFIC THERAPY BEYOND SUPPORTIVE CARE
Campylobacter jejuni Azithromycin 12mg/kg/day PO for 5 days or
Erythromycin 30–50mg/kg/day, divided, tid PO for 5–7 days
Clostridium difficile Metronidazole 30mg/kg/day, divided, QID PO for 7–10 days or
Escherichia coli Azithromycin 12mg/kg/day PO for 5 days or
Trimethoprim-sulfamethoxazole 10mg (TMP)/kg/day PO divided BID for 5–7 days
Giardia lamblia Metronidazole 15mg/kg/day PO, divided, tid for 5 days
Salmonella species In toxic infants <3 mo:
Ampicillin 200mg/kg/24 hours q6h for 7–10 days and
Gentamicin 5–7.5mg/kg/24 hours q8h IV
Shigella species Azithromycin 12mg/kg/day PO for 5 days or
Trimethoprim-sulfamethoxazole 10mg (TMP)/kg/day, divided, BID for 5–7 days if susceptible
Yersinia enterocolitica If patient is immunosuppressed, treat as for presumed sepsis
Vibrio cholera None; severe diarrhea or cholera may benefit from antibiotics

See Also

References