Diarrhoea in IC
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In immunocompromised state (eg RVI)
Small bowel / enteritis usually high volume, watery, faecal leucocyte negative and usually with nausea, vomiting, bloating, midumbilical cramps, weight loss with malabsorption.
Colonic diarrhoea usually small volume with urgent loose stools, lower abdominal pain with faecal positive leucocytes a/w +/- blood.
Opportunistic infection usually occur in CD4 <100
Initial Diagnostic approach:
1. Freshly collected stool
- bacterial culture (salmonella, campylobacter, shigella)
- ova and cysts and parasites
- faecal leucocytes
- Clostridium difficile toxin
- enteric pathogens
- mycobacterium avium intracellulare
- Giardia, CMV, cryptosporidium and microsporida with monoclonal antibody, modified acid fast and trichrome
edited 13th July 2010