title: Staphylococcal enterocolitis: forgotten but not gone?
abstract: OBJECTIVE
  Staphylococcus aureus may cause antibiotic-associated diarrhea and enterocolitis, with or without preceding antibiotic use, in immunocompromised adults or infants, or individuals with predisposing conditions, but there is little appreciation of this condition clinically. CLINICAL DISEASE: The main clinical feature that helps to differentiate staphylococcal enterocolitis (SEC) from Clostridium difficile-associated diarrhea is large-volume, cholera-like diarrhea in the former case. A predominance of gram-positive cocci in clusters on gram stain of stool or biopsy specimens and the isolation of S. aureus as the dominant or sole flora support the diagnosis.
  
  
  METHODS
  The pathogenesis of SEC requires the interaction of staphylococcal enterotoxins, which function as superantigens, with interstitial epithelial lymphocytes and intestinal epithelial cells (IECs).
  
  
  RESULTS
  Most SEC represents recent S. aureus acquisition, so that improved infection prevention practices can reduce disease recurrence. Management should include aggressive fluid management and repletion and oral vancomycin.
authors.affiliation: Division of Gastroenterology, Department of Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY 10025, USA.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Lin
authors.forename: Donald P
authors.initials: DP
authors.lastname: Kotler
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Schlievert
authors.forename: Emilia Mia
authors.initials: EM
authors.lastname: Sordillo
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004760:Enterocolitis / Q000175:diagnosis* / Q000276:immunology / Q000382:microbiology* / Q000628:therapy*; D005440:Fluid Therapy; D006801:Humans; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin