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Clinical Practice
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Volume 350:38-47 January 1, 2004 Number 1
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Acute Infectious Diarrhea
Nathan M. Thielman, M.D., M.P.H., and Richard L. Guerrant, M.D.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

An otherwise healthy 23-year-old man presents after the acute onset of watery diarrhea that has persisted for two days. He reports associated nausea and cramping but no emesis and is febrile, with a temperature of 38.7°C (101.7°F). How should he be evaluated and treated?

The Clinical Problem

Despite reductions in mortality worldwide, diarrhea still accounts for more than 2 million deaths annually1 and is associated . . . [Full Text of this Article]

Strategies and Evidence

Microbiology

Evaluation

Approaches to Therapy

            Rehydration and Nutrition

            Nonspecific Symptomatic Therapy

            Antimicrobial Therapy

Community-Acquired Pathogens

Empirical Antibiotic Treatment for Community-Acquired Illness

Traveler's Diarrhea

Nosocomial Diarrhea

Persistent Diarrhea

Areas of Uncertainty

Guidelines

Conclusions and Recommendations


Source Information

From the Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, N.C. (N.M.T.); and the Department of Medicine, Division of Infectious Diseases and International Health and the Center for Global Health, University of Virginia School of Medicine, Charlottesville (R.L.G.).

Address reprint requests to Dr. Guerrant at the Center for Global Health, HSC #801379, University of Virginia School of Medicine, Charlottesville, VA 22908, or at rlg9a@virginia.edu.


Related Letters:

Acute Infectious Diarrhea
Marignani M., Angeletti S., Delle Fave G., Guerrant R. L., Thielman N. M.
Extract | Full Text | PDF  
N Engl J Med 2004; 350:1576-1577, Apr 8, 2004. Correspondence

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