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Chapter 17 : Gastrointestinal Infections

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Gastrointestinal Infections, Page 1 of 2

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Abstract:

Gastrointestinal infections in the immunocompromised host are caused by the common bacterial, viral, fungal, and parasitic agents that also cause infections in the immunocompetent host. Lower gastrointestinal infections may be associated with fever, abdominal pain, nausea, vomiting, and diarrhea. Noncompliance with medications is a major risk factor for development of opportunistic infections. Other risk factors for developing gastrointestinal infections in the compromised host include the use of cytokine antagonists and newer immunotherapies that deplete lymphocyte subpopulations. Watery and persistent diarrhea is the most common manifestation in children; fever and vomiting are also relatively common. Disseminated visceral disease syndrome is the most common clinical presentation in AIDS patients (~70%). Due to the numerous microbial agents causing gastrointestinal infections in the immunocompromised patient, the diagnostic workup can be both prolonged and costly. There are several approaches to differential diagnosis of immunocompromised patients with gastrointestinal infections. Patients with uncomplicated acute gastroenteritis may be classified as having either community-acquired, nosocomially acquired, or persistent infections, as suggested by the Infectious Diseases Society of America. The approach to the diagnosis of gastrointestinal infections, particularly diarrheal illnesses, in the immunocompromised host is rather complex, and there is no simple diagnostic algorithm to follow.

Citation: Nachamkin I. 2009. Gastrointestinal Infections, p 379-390. In Hayden R, Carroll K, Tang Y, Wolk D (ed), Diagnostic Microbiology of the Immunocompromised Host. ASM Press, Washington, DC. doi: 10.1128/9781555815455.ch17

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Lower Gastrointestinal Tract
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Upper Gastrointestinal Tract
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Infectious Diseases
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Figure 1.

Microbial agents causing upper and lower gastrointestinal infections in the compromised host.

Citation: Nachamkin I. 2009. Gastrointestinal Infections, p 379-390. In Hayden R, Carroll K, Tang Y, Wolk D (ed), Diagnostic Microbiology of the Immunocompromised Host. ASM Press, Washington, DC. doi: 10.1128/9781555815455.ch17
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Image of Figure 2.
Figure 2.

Algorithm for diagnostic approach to lower gastrointestinal infections in the compromised host.

Citation: Nachamkin I. 2009. Gastrointestinal Infections, p 379-390. In Hayden R, Carroll K, Tang Y, Wolk D (ed), Diagnostic Microbiology of the Immunocompromised Host. ASM Press, Washington, DC. doi: 10.1128/9781555815455.ch17
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Tables

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Table 1.

Microbial agents causing more severe or complicated gastrointestinal infection in the immunocompromised host

Citation: Nachamkin I. 2009. Gastrointestinal Infections, p 379-390. In Hayden R, Carroll K, Tang Y, Wolk D (ed), Diagnostic Microbiology of the Immunocompromised Host. ASM Press, Washington, DC. doi: 10.1128/9781555815455.ch17

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