Algorithm for the Evaluation of Acute Diarrhea (< 7 days)

Are the following present?

   1. Severe illness: T > 38.50C, abdominal pain, bloody diarrhea, > 6 stools/24 h, dehydration

   2. Immunocompromised patient: AIDS, post-transplantation

   3. Elderly patient (> 70 yrs)

Send stool for following:

   1. Fecal leukocytes

   2. Routine stool culture

   3. C difficile assay, if recent hospitalization or antibiotics

   4. Ova and parasite testing, if:

         a. Diarrhea > 10 days

         b. Travel to endemic region

         c. Community water-borne outbreak

         d. HIV infection or men who have sex with men

Consider empiric antibiotic therapy while awaiting culture, if:

   1. Fecal leukocyte positive

   2. Bloody diarrhea, fever, abdominal pain

   3. Dehydration or > 8 stools/24 h

   4. Immunocompromised

   5. Hospitalization required



#Acute #Diarrhea #management #algorithm #workup #diagnosis