2001/02/01 by Richard L. Guerrant, Thomas Van Gilder, Ted S. Steiner +14 · 1 citation
Medicine · Agricultural and Biological Sciences · Biochemistry, Genetics and Molecular Biology · #Viral gastroenteritis research and epidemiology #Salmonella and Campylobacter epidemiology #Escherichia coli research studies #Medicine #Diarrhea #Intensive care medicine #Internal medicine
paper · pdf · doi:10.1086/318514
openalex publication_date 2001/02/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
The widening array of recognized enteric pathogens and the increasing demand for cost-containment sharpen the need for careful clinical and public health guidelines based on the best evidence currently available. Adequate fluid and electrolyte replacement and maintenance are key to managing diarrheal illnesses. Thorough clinical and epidemiological evaluation must define the severity and type of illness (e.g., febrile, hemorrhagic, nosocomial, persistent, or inflammatory), exposures (e.g., travel, ingestion of raw or undercooked meat, seafood, or milk products, contacts who are ill, day care or institutional exposure, recent antibiotic use), and whether the patient is immunocompromised, in order to direct the performance of selective diagnostic cultures, toxin testing, parasite studies, and the administration of antimicrobial therapy (the latter as for traveler's diarrhea, shigellosis, and possibly Campylobacter jejuni enteritis). Increasing numbers of isolates resistant to antimicrobial agents and the risk of worsened illness (such as hemolytic uremic syndrome with Shiga toxin-producing Escherichia coli O157:H7) further complicate antimicrobial and antimotility drug