Gastrointestinal Pathogens Causing Acute Diarrhea
| Mechanism | Location | Illness | Stool Findings | Examples of Pathogens Involved |
|---|---|---|---|---|
| Noninflammatory (enterotoxin) | Proximal small bowel | Watery diarrhea | No fecal leukocytes; mild or no increase in fecal lactoferrin | Vibrio cholerae, enterotoxigenic Escherichia coli (LT and/or ST), enteroaggregative E. coli, Clostridium perfringens, Bacillus cereus, Staphylococcus aureus, Aeromonas hydrophila, Plesiomonas shigelloides, rotavirus, norovirus, enteric adenoviruses, Giardia lamblia, Cryptosporidium spp., Cyclospora spp., microsporidia |
| Inflammatory (invasion or cytotoxin) | Colon or distal small bowel | Dysentery or inflammatory diarrhea | Fecal polymorphonuclear leukocytes; substantial increase in fecal lactoferrin | Shigella spp., Salmonella spp., Campylobacter jejuni, enterohemorrhagic E. coli, enteroinvasive E. coli, Yersinia enterocolitica, Listeria monocytogenes, Vibrio parahaemolyticus, Clostridium difficile, A. hydrophila, P. shigelloides, Entamoeba histolytica, Klebsiella oxytoca |
| Penetrating | Distal small bowel | Enteric fever | Fecal mononuclear leukocytes | Salmonella typhi, Y. enterocolitica |
Abbreviations: LT, heat-labile enterotoxin; ST, heat-stable enterotoxin.