Jost R
Departement Innere Medizin, Universitätsspital Zürich.
Schweiz Rundsch Med Prax. 1993 Apr 20;82(16):490-4.
Acute diarrhea is most commonly caused by infectious agents. The first step in the evaluation is based on the medical history, clinical presentation and simple stool examinations (fecal leukocytes and occult blood). Thereby it can be decided, whether a microbial identification or an antibiotic therapy are indicated. In case of viral or noninvasive, enterotoxinogenic diarrhea oral rehydration is sufficient, whereas enteroinvasive diarrhea or enteric syndromes need further evaluation by stool and blood cultures. Depending on the clinical situation and the result of cultures, an appropriate or empiric therapy with antibiotics is indicated in acute febrile dysentery, shigellosis, cholera, typhoid fever, severe salmonellosis and Cl. difficile colitis.
急性腹泻最常见的病因是感染因素。评估的第一步基于病史、临床表现和简单的粪便检查(粪便白细胞和潜血)。由此可以决定是否需要进行微生物鉴定或抗生素治疗。对于病毒性或非侵袭性、产肠毒素性腹泻,口服补液就足够了,而侵袭性腹泻或肠道综合征则需要通过粪便和血培养进行进一步评估。根据临床情况和培养结果,急性发热性痢疾、志贺菌病、霍乱、伤寒、重症沙门菌病和艰难梭菌结肠炎需要使用抗生素进行适当治疗或经验性治疗。