Diarrhea (peds): Difference between revisions
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**Adenoviruses | **Adenoviruses | ||
*Bacterial | *Bacterial | ||
**Salmonella | **[[Salmonella]] | ||
**Shigella | **[[Shigella]] | ||
**Yersinia | **[[Yersinia]] | ||
**Campylobacter | **[[Campylobacter]] | ||
**Escherichia coli | **[[Escherichia coli]] | ||
**Vibrio species | **[[Vibrio]] species | ||
**Clostridium difficile | **[[Clostridium difficile]] | ||
**TB | **[[TB]] | ||
*Parasitic | *Parasitic | ||
**Giardia | **[[Giardia]] | ||
**Entamoeba | **[[Entamoeba]] | ||
**Cryptosporidia | **[[Cryptosporidia]] | ||
=== Dietary disturbances === | === Dietary disturbances === | ||
*Overfeeding | *Overfeeding | ||
*Food allergy | *Food allergy | ||
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=== Anatomic abnormalities === | === Anatomic abnormalities === | ||
*[[Intussusception]] | |||
*Intussusception | |||
*Hirschsprung disease | *Hirschsprung disease | ||
*Partial obstruction | *Partial obstruction | ||
*Appendicitis | *[[Appendicitis]] | ||
*Blind loop syndrome | *Blind loop syndrome | ||
*Intestinal lymphangiectasia | *Intestinal lymphangiectasia | ||
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=== Systemic diseases === | === Systemic diseases === | ||
*Immunodeficiency | *Immunodeficiency | ||
*Endocrinopathy | *Endocrinopathy | ||
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=== Miscellaneous === | === Miscellaneous === | ||
*[[Inflammatory bowel disease]] | |||
*Inflammatory bowel disease | |||
*Antibiotic-associated diarrhea | *Antibiotic-associated diarrhea | ||
*Secondary lactase deficiency | *Secondary lactase deficiency | ||
*Irritable colon syndrome | *Irritable colon syndrome | ||
*Neonatal drug withdrawal | *Neonatal drug withdrawal | ||
*Toxins | *[[Toxins]] | ||
*Hemolytic uremic syndrome | *[[Hemolytic uremic syndrome]] | ||
== Treatment == | == Treatment == |
Revision as of 08:38, 7 June 2015
Differential Diagnosis
Infection
- Viral
- Rotavirus
- Norwalk virus
- Enteroviruses
- Adenoviruses
- Bacterial
- Parasitic
Dietary disturbances
- Overfeeding
- Food allergy
- Starvation stools
Anatomic abnormalities
- Intussusception
- Hirschsprung disease
- Partial obstruction
- Appendicitis
- Blind loop syndrome
- Intestinal lymphangiectasia
- Short bowel syndrome
Malabsorption or secretory diseases
- Cystic fibrosis
- Celiac disease
- Disaccharidase deficiency
- Secretory neoplasms
Systemic diseases
- Immunodeficiency
- Endocrinopathy
- Hyperthyroidism
- Hypoparathyroidism
- Congenital adrenal hyperplasia
Miscellaneous
- Inflammatory bowel disease
- Antibiotic-associated diarrhea
- Secondary lactase deficiency
- Irritable colon syndrome
- Neonatal drug withdrawal
- Toxins
- Hemolytic uremic syndrome
Treatment
General Treatment
If bloody diarrhea, use caution with beginning antibioitics 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).
See Diarrhea
Diarrheal Pathogens in Children and Specific Therapy
AGENT | SPECIFIC THERAPY BEYOND SUPPORTIVE CARE |
---|---|
Campylobacter jejuni | Azithromycin 12 mg/kg/day PO for 5 days or |
Erythromycin 30–50 mg/kg/day, divided, tid PO for 5–7 days | |
Clostridium difficile | Metronidazole 30 mg/kg/day, divided, qid PO for 7–10 days or |
Escherichia coli | Azithromycin 12 mg/kg/day PO for 5 days or |
Trimethoprim-sulfamethoxazole 10 mg (TMP)/kg/day PO divided bid for 5–7 days | |
Giardia lamblia | Metronidazole 15 mg/kg/day PO, divided, tid for 5 days |
Salmonella species | In toxic infants <3 mo: Ampicillin 200 mg/kg/24 hours q6h for 7–10 days and Gentamicin 5–7.5 mg/kg/24 hours q8h IV |
Shigella species | Azithromycin 12 mg/kg/day PO for 5 days or |
Trimethoprim-sulfamethoxazole 10 mg (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 |