difference in diarrhea of small and large infections

 Q: When only the small bowel is involved in enteritis, fever is rarely present? (select one)

A) True

B) False

Answer: A

The few important clues to distinguish between diarrhea due to small and large bowel infections is the presence or absence of fever, occult blood, or inflammatory cells. 

When only the small bowel enteritis is present fever, occult blood, or inflammatory cells are usually absent. It is mostly characterized by a large volume watery diarrhea, cramping, and bloating. The common causes are viruses. 

In the large bowel infectious colitis, fever, bloody or mucoid stools are universally present, and RBCs and inflammatory cells are routinely seen on stool smear. The symptom is usually frequent, small-volume, painful diarrhea. The common causes are bacteria.

#infectious-diseases 

References:

1. Wanke C, Guerrant R. Infectious gastroenteritis. In: Medicine for the Practicing Physician, 4th Ed, Hurst J (Ed), Appleton & Lange, Stamford, CT 1996. p.340. 

2. Wanke CA. Small intestinal infections. Curr Opin Gastroenterol 1994; 10:59. 

3. Guerrant RL, Van Gilder T, Steiner TS, et al. Practice guidelines for the management of infectious diarrhea. Clin Infect Dis 2001; 32:331.