Acute Infectious

Diarrheal Diseases
BUCM Clerk Lavadia-Gumabao, Maria Francesca
BCCM Clerk – Hirek Kikani
 DIARRHEA
- Frequent passage of abnormally
liquid or unformed stools
- >200g/d

Acute: <2 weeks

Chronic: >4 weeks

Lavadia-Gumabao, MFQ
 Pathogenic Mechanisms

Inoculum Size Toxin Production

01 Ex. Shigella, Entamoeba – 10 to 100
Cholera – 105 to 108
03 a.
b.
Enterotoxin
Cytotoxin

Adherence Invasion
02 - Initial step in pathogenic process
- Cell-surface proteins
04 Shigella & E. coli  invasion of mucosal
epithelial cells, intraepithelial multiplication,
Ex. V. cholera – brush-border of small intestine subsequent spread to adjacent cells
via surface Adhesins Salmonella  invasion of bowel mucosa

Lavadia-Gumabao, MFQ
 Host Defenses

Intestinal
Microbiota
Gastric Acid
Composition & number Intestinal Motility
of organisms Presentation of Proliferation of
Binding of
Mucosal Immune Ag to sensitized
Bacterial Ag to M
System Subepithelial lymphocytes
cells &
Lymphoid Tissue

Intestinal Genetic
Mucin Immunity
Determinants

Lavadia-Gumabao, MFQ
 Lavadia-Gumabao, MFQ

(+) blood = bowel

Duration: with
perforation, infections Proctitis (Shigellosis
Acute <2 weeks
Systemic
enterohemorrhagic e. coli or Amebiasis)
Bulky white stools =
malabsorption
Rice watery stool =
Cholera