1. Dysentery

- Culture and treat with appropriate antibiotics

Typical organisms: 

- Campy

- Salmonella

- E.coli (STEC- makes shiga toxin, EIEC - similar to shigella)

- Shigella

- C.Diff

2. Campy

- Often has prodrome, flu like illness

- Azithro 

3. Salmonella

- Turtles, reptiles

- Cipro 

4. STEC e.coli (O157-H7) aka EHEC 

- No fever, only bloody diarrhea, a lot of abdominal pain 

- Cecal/colonic wall thickening - Can present clinically like appendicitis

- Don't treat, just let it run its course-- In kids, the data seems to show that the ones who get antibiotics are more likely to get HUS 

5. Shigella

- Tends to be more L sided. 

- Cipro 

6. C.Diff

- There exists community acquired C.diff

- If someone comes in w bloody diarrhea, send c.diff toxin as well 

- PPIs/NSAIDs are also linked-- PPIs are almost as closely linked as antibiotics 

7. Community antibiotic-associated minor diarrhea without blood

- stop the antibiotics 

- Likely just a consequence of changing bowel flora, give probiotics

- In community, odds of C.diff in sb on antibiotics with diarrhea ~15%

8. Giardia

- Recreational water facilities 

- Treat empirically with flagyl, as it's notoriously hard to find/culture from the stool. 

9. Algorithm for diagnosing diarrhea: 

10. Types of E.Coli:

- STEC : shiga-toxin producing e-coli (O157-H7) formerly known as EHEC and many others

- ETEC : enterotoxigenic e.coli - watery, traveler's

- EPEC : enteropathogenic e.coli- watery diarrhea in adults and kids 

- EIEC : enteroinvasive, bloody diarrhea with tenesmus, similar to Shigella

- EAEC : enteroaggregative - a different cause of traveler's diarrhea