Differentials
Shigellosis
SIGNS / SYMPTOMS
Diarrhoea, often bloody.
Usually due to faecal-oral contact or ingestion of contaminated food or water.
Most commonly seen in children <5 years of age.
INVESTIGATIONS
Identification of Shigella species in the stool.
Campylobacter species infection
SIGNS / SYMPTOMS
Acute diarrhoea.
Usually due to ingestion of contaminated food, most commonly undercooked poultry.
INVESTIGATIONS
Identification of Campylobacter species in the stool.
Yersiniosis
SIGNS / SYMPTOMS
Diarrhoeal illness that is usually due to ingestion of undercooked meat, especially pork.
Most commonly causes an enterocolitis in young children, who often have bloody stools. Older children may also get terminal ileitis and mesenteric adenitis that cause appendicitis-type symptoms. Adults with yersiniosis have gastroenteritis with diarrhoea and abdominal pain.
INVESTIGATIONS
Identification of Yersinia species in the stool.
Escherichia coli infection
SIGNS / SYMPTOMS
Diarrhoea that is bloody if caused by enterohaemorrhagic E coli.
Most commonly a foodborne illness.
INVESTIGATIONS
Identification of enteropathogenic E coli in the stool.
Vibrio species infection
SIGNS / SYMPTOMS
Diarrhoea, often profuse and watery.
Skin infection may be present.
Associated with the consumption or handling of raw or undercooked shellfish or traumatic exposure to salt water.
INVESTIGATIONS
Identification of Vibrio species in the stool.
Listeriosis
SIGNS / SYMPTOMS
Diarrhoeal illness usually associated with ingestion of contaminated food.
INVESTIGATIONS
Identification of Listeria monocytogenes in the stool.
Gastroenteritis caused by viruses such as norovirus, rotavirus, astrovirus, or adenovirus
SIGNS / SYMPTOMS
Viral gastroenteritis often has predominantly upper gastrointestinal symptoms such as nausea and vomiting, but may also manifest as diarrhoea.
INVESTIGATIONS
Differentiation is made by obtaining stool samples and identifying the causative organism.
Gastroenteritis caused by parasitic agents such as Cryptosporidium or Cyclospora
SIGNS / SYMPTOMS
Parasitic conditions typically have a longer duration of illness.
Epidemiological clues to a parasitic cause may include travel and exposure histories, but Salmonella also may be acquired both locally and in tropical locations.
INVESTIGATIONS
Differentiation is made by obtaining stool samples and identifying the causative organism.
Gastroenteritis by preformed toxins (staphylococcal) or food poisoning
SIGNS / SYMPTOMS
Presents with mostly upper gastrointestinal symptoms and has a short incubation period of usually 2 to 4 hours. Fever is uncommon.
INVESTIGATIONS
Differentiation is made by obtaining stool studies and identifying the causative organism.
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