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Organism Region Vibrio cholerae Tropics Incubation period 1–3 Azithromycin (20 Particularly days mg/kg as a single South Asia, Painless voluminous dose; maximum Southeast dose: g) watery (rice-water) Asia, and diarrhea without Africa abdominal cramps or fever Complications include dehydration, hypokalemia, metabolic acidosis, hypovolemic shock, coma, seizures, and death Worldwide Incubation period 10 Azithromycin (6–20 hrs–6 days mg/kg/day for 1–5 days; maximum Enteropathic and daily dose: 1,000– enterotoxigenic: 1,500 mg) or self-limited to fluoroquinolones watery diarrhea with (e.g., ciprofloxacin abdominal cramps 15 mg/kg twice Shiga-toxin producing daily for days; (STEC): maximum: 500 hemorrhagic colitis mg/dose); —bloody or rifaximin (200 mg nonbloody stool tid × days) can be Enteroinvasive: bloody used in children or nonbloody ≥12 yo diarrhea with fever Administration of Enteroaggregative: antibiotics to watery and children with occasionally bloody STEC infection is diarrhea controversial E coli Clinical manifestations Treatment Campylobacter Worldwide species Incubation period 2–5 Azithromycin (10 days mg/kg daily for days) or Diarrhea (bloody or erythromycin (10 nonbloody), mg/kg every hrs abdominal pain, for days) malaise, and fever Can cause Fluoroquinolone bacteremia in young resistance in the children United States is seen in up to 34% of isolates, and this class of antibiotics is not approved for Campylobacter infection in the United States e-TABLE 94.23 CLINICAL MANIFESTATIONS AND DIAGNOSIS OF SCHISTOSOMIASIS Site Species Katayama fever All Symptoms Diagnosis Fever, malaise, cough, Serology; can help rash, abdominal pain, with speciation, nausea, diarrhea, but cannot tender differentiate hepatosplenomegaly, ongoing infection, lymphadenopathy, and recent infection, or eosinophilia past infection Intestinal S mansoni, S Low worm burden: may Identification of eggs japonicum, be asymptomatic or in the stool S mekongi, have mild symptoms (several specimens S may be necessary) Moderate–severe worm intercalatum burden: mucoid bloody diarrhea, tender hepatomegaly Late findings: portal hypertension, ascites, esophageal varices, and hematemesis Urinary S hematobium Dysuria, urgency, Microscopic frequency; examination of microscopic or gross urine (egg hematuria Late excretion in urine findings: bladder typically peaks fibrosis and bladder between noon and cancer pm); bladder biopsy may be necessary Genital tract S hematobium Males: obstructive Microscopic uropathy, rare examination of involvement of urine (egg prostate, testes, excretion in urine epididymis, and penis typically peaks between noon and Females: ulcerating pm) polypoid or nodular lesions of the vulva,
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