Suarez J, Salamone F R
Division of Pharmacy Services, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Clin Pharm. 1988 Oct;7(10):746-59.
The etiology, pathogenesis, transmission and communicability, diagnosis, and management of infectious diarrhea are reviewed. Infectious diarrhea is common in both industrialized and unindustrialized areas of the world. Better understanding of the etiology and pathogenesis and identification of "new" enteric pathogens has resulted in the use of a variety of drugs to relieve symptoms or to effect a clinical cure. Both host and microbial virulence factors are key in the acquisition of diarrheal illness. Host factors such as extreme age, a dysfunctional gastrointestinal tract, or underlying immunodeficiency enhance the risk of illness after ingestion of a pathogen or its toxins. Microbial virulence factors (the pathogen's ability to invade or produce enterotoxins, neurotoxins, or cytotoxins) characterize the type of illness manifested and the symptom complex (e.g., acute watery diarrhea versus chronic dysentery). Supportive care is indicated in the majority of cases of infectious enteritis, and rehydration is considered the mainstay of therapy in any diarrheal illness accompanied by dehydration. Antimicrobial therapy is beneficial in the treatment of severe diarrhea caused by Shigella, Campylobacter spp., Vibrio cholerae, Escherichia coli, and Clostridium difficile. Infectious diarrhea is common but is often self-limited and of short duration. Therapy frequently consists of symptomatic relief and fluid replacement.
本文综述了感染性腹泻的病因、发病机制、传播与传染性、诊断及管理。感染性腹泻在世界工业化和非工业化地区均很常见。对病因和发病机制的深入了解以及“新型”肠道病原体的发现，促使人们使用多种药物来缓解症状或实现临床治愈。宿主和微生物毒力因子都是导致腹泻病的关键因素。宿主因素，如年龄极端、胃肠道功能失调或潜在免疫缺陷，会增加摄入病原体或其毒素后患病的风险。微生物毒力因子（病原体侵入或产生肠毒素、神经毒素或细胞毒素的能力）决定了所表现出的疾病类型和症状复合体（例如，急性水样腹泻与慢性痢疾）。在大多数感染性肠炎病例中，支持性护理是必要的，而补液被视为任何伴有脱水的腹泻病治疗的主要手段。抗菌治疗对由志贺菌、弯曲杆菌属、霍乱弧菌、大肠杆菌和艰难梭菌引起的严重腹泻有效。感染性腹泻很常见，但通常为自限性且病程较短。治疗通常包括缓解症状和补充液体。
