Section 4 / Chapter III Diarrheal Diseases

Organism	Vehicle	Mechanism	Classic Characteristics	Complications
Campylobacter	Food (poultry); animal-to-person	Invasion; inflammation	Watery or blood diarrhea; ileitis and/or colitis, ulceration	Guillain-Barré syndrome; reactive arthritis
Salmonella	Food (poultry, eggs, seafood); animal-to-person	Invasion; inflammation	Gastroenteritis, ileitis, colitis; enteric fever (S. typhi)	Endovascular infection; osteomyelitis; sepsis
Shigella	Food (poultry); day care centers	Cytotoxin; inflammation	Two phases: enteritis (fever, cramps, diarrhea), followed by colitis (ulcers, inflammation)	Seizures, encephalopathy; reactive arthritis
E. coli O157:H7	Food (beef); fruit juices	Cytotoxin	Hemorrhagic colitis	Hemolytic-uremic syndrome
Enteroinvasive E. coli	Food (various); water	Invasion; inflammation	Colitis	Fever, sepsis
Enterotoxigenic E. coli	Food (various); water	Enterotoxin	Watery diarrhea	Dehydration, shock
Enteropathogenic and enteroadherent E. coli	Food (various); water	Contact with brush border	Watery diarrhea; may be prolonged	Dehydration
Vibrio cholerae	Water, seafood	Enterotoxin	Voluminous watery diarrhea	Dehydration, shock
Clostridium difficile	Person-to-person	Cytotoxin	Nosocomial infection; antibiotic-associated diarrhea; toxicity	Toxic megacolon; protein-losing enteropathy
Aeromonas, Plesiomonas	Water	Enterotoxin	Watery diarrhea; may be prolonged
Yersinia	Raw milk	Invasion; inflammation	Acute diarrhea or chronic ileocolitis-like Crohn disease	Reactive arthritis, extaintestinal infection, Guillain-Barré syndrome
Bacillus cereus	Fried rice	Exotoxin	Acute gastroenteritis	Fulminant liver failure
Staphylococcus	Fatty foods	Exotoxin	Acute gastroenteritis
Clostridiumperfringens	Fatty foods	Exotoxin	Acute gastroenteritis
Viruses	Person-to-person; water	Inflammation; ?toxins	Acute gastroenteritis; watery diarrhea
Giardia	Person-to-person; animal-to-person; water; day care	Contact	Watery diarrhea, dyspepsia
Cryptosporidium	Water; day care; animal-to-person	Contact	Watery diarrhea, may be prolonged; epidemics
Cyclospora	Imported fruit	Inflammation	Watery diarrhea, flatulence, pain, fatigue; may be prolonged
Entamoeba histolytica	Person-to-person	Invasion; inflammation	Variable: asymptomatic to dysentery; may mimic irritable bowel syndrome, inflammatory bowel disease	Liver abscess
Strongyloides	Larvae invade skin	Invasion; inflammation	Abdominal pain and diarrhea	Hyperinfection in immunosuppressed hosts