GASTROENTEROLOGY ARTICLE OF THE WEEK
March 18, 2004
Thielman NM, Guerrant RL. Acute infectious diarrhea. N Engl J Med 2004;350:38-47
1. The non-viral pathogen most commonly responsible for diarrhea in the year 2002 was a. E coli
b. Campylobacter jejuni
c. Salmonella
d. Shigella
e. Cryptosporidium
2. During evaluation of the patient with acute diarrhea, a stool culture should be performed in:
a. All patients with acute diarrhea
b. Diarrhea of <24 h duration, with no toxic signs and symptoms
c. Patients with pus in the stool
d. Patients with fever and diarrhea
e. Patients with watery diarrhea even if no dehydration or fever
3. Antibiotics have been found to be beneficial for which of the following causes of acute diarrhea
a. shigellosis
b. campylobacter if given within 4 days of onset of symptoms
c. uncomplicated salmonella diarrhea in immunocompetent hosts
d. salmonella diarrhea in patients with prosthetic joints
e. salmonella diarrhea in patients taking corticosteroids
f. bloody diarrhea without fever after eating poorly cooked hamburgers
True or False
4. Most diarrheal illnesses occur during the winter months and in adults the most likely cause are noroviruses.
5. Lactoferrin has a higher sensitivity and specificity for the detection of inflammatory diarrhea when compared to stool test for PMN’s.
6. Bloddy diarrhea secondary to E. coli O157:H7 typically presents with fever.
7. The use of loperamide should be avoided as single agent in patients with bloody diarrhea or suspected inflammatory diarrhea, but can be safely used in other adults with acute diarrhea.
8. Fluoroquinolones are effective for patients with Campylobacter diarrhea who have a prolonged symptomatic course.
9. Antimicrobial prophylaxis to prevent traveler’s diarrhea is recommended for immunocompromised adults.
