title: Nosocomial diarrhea: a review of pathophysiology, etiology, and treatment strategies.
abstract: Diarrhea is a frequent complication among hospitalized patients. Nosocomial diarrhea is generally diagnosed as increased frequency and decreased consistency of stools developing after 72 hours of hospitalization. The causes of nosocomial diarrhea may be infectious or noninfectious. Noninfectious etiologies occur most commonly, and are often adverse effects of medications or enteral nutrition therapies. Infectious etiologies are most concerning and include Clostridium difficile and norovirus. Patients with nosocomial diarrhea should be placed in isolation with contact precautions in place until the presence of C difficile infection is determined. Irrespective of etiology, diarrhea can cause serious complications in hospitalized patients, including malnutrition, hemodynamic instability, metabolic acidosis, and potentially fatal pseudomembranous colitis. This article reviews nosocomial diarrhea, including its pathophysiology, infectious and noninfectious causes, and treatment strategies based on identified cause.
authors.affiliation: Avera McKennan Hospital and University Health Center, Sioux Falls, SD 57117, USA. billie.bartel@avera.org
authors.forename: Billie
authors.initials: B
authors.lastname: Bartel
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gau
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D017250:Caliciviridae Infections / Q000503:physiopathology / Q000628:therapy; D016360:Clostridioides difficile; D003428:Cross Infection / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D003967:Diarrhea / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D004750:Enteral Nutrition / Q000009:adverse effects; D005440:Fluid Therapy; D006801:Humans; D029322:Norovirus
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents