Summary
Definition
History and exam
Key diagnostic factors
- diarrhoea
- history of travel, contact with contaminated food, or contact with infected person
Other diagnostic factors
- abdominal pain or discomfort
- volume depletion
- fever
- nausea/vomiting
- anorexia
- lethargy
Risk factors
- ingestion of contaminated food products or water
- travel
- poor hygiene practices
- infantile or advanced age (<5 years and >60 years)
- contact history
- immunocompromised state
- contact with infected animals
Diagnostic investigations
Investigations to consider
- identification of Shiga toxin-producing E coli infection
- blood cultures
- inflammatory markers (CRP and/or erythrocyte sedimentation rate)
- abdominal x-ray
- endoscopy
- abdominal CT scan
Treatment algorithm
Contributors
Authors
Eli D. Ehrenpreis, MD, FACG, AGAF
Associate Director for Research
Internal Medicine Residency
Advocate Lutheran General Hospital
Park Ridge
IL
Disclosures
EDE is a CEO for E2Bio Life Sciences LLC and G.I. Pharmaceuticals Inc. E2Bio Life Sciences LLC has developed Bocaliner, an FDA-registered class 1 medical device designed to enhance the efficacy of topical medicines applied to the oral cavity. G.I. Pharmaceuticals Inc. has medical treatments for oral leukoplakia designed to prevent oral cancer, and a new medicine for anal pruritis.
Acknowledgements
Dr Eli D. Ehrenpreis would like to gratefully acknowledge the assistance of Dr Thomas Adam Wichelmann, who contributed to this update. Dr Ehrenpreis would also like to acknowledge Dr Alexandra Kent and Professor Satis Keshav, the previous contributors to this topic.
Disclosures
TAW, AK, and SK declare that they have no competing interests.
Peer reviewers
Andrew Poullis, BSc, MBBS, MD, FRCP
Consultant Gastroenterologist
St George’s Hospital
London
UK
Disclosures
AP declares that he has no competing interests.
Fiona Cooke, MA, PhD, MSc, FRCPath, MRCP, DTM&H
Research Fellow and Medical Microbiologist
Wellcome Trust Sanger Institute
Department of Microbiology
Addenbrooke's Hospital
Cambridge
UK
Disclosures
FC declares that she has no competing interests.
Houssam E. Mardini, MD, MPH, FACP
Voluntary Assistant Professor of Medicine
Digestive Health & Nutrition Center of Ashland
Ashland
KY
Disclosures
HEM declares that he has no competing interests.
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