Acute diarrhoea and fever

S Dundas, Consultant Physician, Infectious Diseases Unit, Monklands District General Hospital, Airdrie, UK
WTA Todd, Consultant Physician, Infectious Diseases Unit, Monklands District General Hospital, Airdrie, UK

Summary

Although infectious agents remain the most common causes of acute diarrhoea and fever amongst otherwise healthy adults, their true incidence remains considerably underestimated and the epidemiology is changing. Campylobacter species are now the most frequently isolated organisms to cause sporadic infective gastroenteritis in the UK. Norovirus infections have increased in importance over the last decade whilst Salmonella infections have declined. Escherischia coli O157 infection has attracted significant media interest but remains a rare if serious cause of illness. A clear history and targeted investigations will help to identify the causative organism. Negative stool cultures are relevant and should lead to consideration of alternative diagnoses. Management involves careful infection control, appropriate fluid replacement, and the avoidance of antibiotic therapy except in specific circumstances. The significant likelihood of alternative, non-infectious causes of acute diarrhoeal illness must be considered, particularly in the elderly.

© Royal College of Physicians of Edinburgh, 2007