Diarrhea • Definition – Pathologic phenomena – Elimination of abnormal quantities of stool and large volume of water (>300g/day) (frequency of bowl movements increase) – Origin • Infectious • Non-infectious

Groupe 2

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Infectious diarrhea : • Secretory diarrhea – Stimulation surface receptors of small intestine (entrocytes) by enterotoxins – Disrupt the physiology of epithelial cells – Large volum, little blood in stool – Staphylococcus aureus, Vibrio cholera, Escherichia coli (ETEC) – Watery diarrhea, risk of dehydration

• Invasive infection – Destruction of enterocytes with bacteria and/orles toxins / virus or parasites – Shigella, Salmonella, E. coli, Yersinia, Campylobacter – Blood in the stool, pain in rectum, fever, ulceration of inner lining

Vibrio cholera

Shigella dysenteriae

Peyer’s patchs

Intestinal infection

Two grand syndrome • Secretory diarrhea • Syndrome choleriform – Mild or not fever – Abdomminal pain – Increased bowl movement – liquid (rice water) – Vomiting – Risk of dehydration and severity

• Invasive diarrhea • Syndrome dysenteriform – – – – –

Fevre - 39-40°C Abdominal pains +++ Mucoid and bloody stool Vomiting Risk of diffusion to extraabdominal regions of infections And severity

• Examination principles – Stool • leucocytosis • Coprocultures (bactério, viro, parasito) – specimen : fresh stool – Rapid transport to laboratory – Bacteriologic result in 48 -72 hours

– Sang • Blood formula • Hémoculture, sérologic

– Aliment / Vomiting • Search for bacteria or toxins

Etiology of invasive diarrhea • • • • •

Salmonella Shigella Yersinia Campylobacter E. coli entero-invasif