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Recenti Progressi in Medicina 2007-Nov

[Acute and prolonged infectious diarrheas, of microbial and viral etiology: methods of clinical and microbiological diagnosis].

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Daniele Crotti
Maria Letizia D'Annibale

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Abstrait

The Authors relate clinical-microbiological criteria for a rational diagnosis of acute and prolonged enteritis, distinguishing between home and imported diarrheas. During 2005, 381 subjects (192 children and 189 adults) with acute diarrhea and 110 subjects (16 children and 94 adults) with prolonged diarrhea were examined. In the first group Salmonella prevailed in 11.1% of cases (10.9% among children and 11.1% among adults); Campylobacter in 9.2% (respectively 8.9% and 9.5%); other bacteria were identified in 3.2% of cases (1.0% and 3.8% respectively). Rotavirus were observed in 29.5% of children and Adenovirus in 6.2% of pediatric population. Pathogenic protozoa were observed in 1.6% of people (0.5% in children and 2.7% in adults). Among second group pathogenic protozoa prevailed in 6.4% (6.3% in children and 6.4% in adults); toxin A of C. difficile were detected in 8.5% of total cases. The Authors emphasize the importance to investigate always for Salmonella, Shigella and Campylobacter; in children with vomiting (with acute non invasive enteritis) is necessary to investigate for Rotavirus too; if the diarrhea is prolonged could be important investigate for toxin A/B of C. difficile and for protozoa with specific stains. Based on clinical and epidemiological findings other pathogens could be researched, if possible for own resources.

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