Main description:

Enteric infection has played an important role in the majority of the world's populations, including children (particularly those under four years of age), the aged, the malnourished, military populations, and per sons from industrialized regions traveling to developing areas. The magni tude of the problem has been profound in areas of the world with reduced economic development, where there exists a greater reservoir of entero pathogens and a larger susceptible population with nutritional deficits. Morbidity from enteric infection in developing areas exceeds that seen in industrialized countries by severalfold, with the problem being most seri ous in infants who are bottle-fed and other infants and young children soon after being weaned from the breast ("weanling diarrhea"). Of greater significance than the inverse relationship of diarrhea morbidity with levels of industrial development is the relationship of death from intestinal infection and socioeconomic advancement. Mortality rate from diarrhea is 10 to 100 times greater in developing areas. In many parts of the third world, diarrhea, resultant dehydration, and associated malnutri tion are the leading causes of death in infants and young children and account for as great as one-third of pediatric deaths.

Contents:

1. Immune Mechanisms in Infectious Diarrhea.- Nonspecific Gastrointestinal Immune Mechanisms.- Gastric Trap.- Intestinal Motility Patterns.- Intestinal Microfiora.- Immunologic Mechanisms in Enteric Infection.- Secretory Immune System.- Cell-Mediated Immunity.- Breast Milk and Gastrointestinal Immunity.- Host Resistance Factors in Human Milk.- Immunologic Control of Enteric Infection.- References.- 2. Amebiasis.- Epidemiology.- Pathogenesis.- Clinical Aspects.- Amebic Colitis.- Liver Abscess.- Complications of Intestinal Amebiasis.- Perforation.- Ameboma.- Stricture.- Miscellaneous Complications.- Diagnosis.- Stool Examination.- Other Laboratory Procedures.- Serology.- Treatment.- References.- 3. Giardiasis.- Pathogenesis.- Epidemiology.- Clinical Aspects.- Diagnosis.- Treatment.- Immunity.- Prevention.- References.- 4. Bacillary Dysentery.- Bacteriology.- Pathogenesis.- Epidemiology.- Clinical Features.- Diagnosis.- Immunology of Shigellosis.- Therapy of Bacillary Dysentery.- References.- 5. Salmonellosis.- Bacteriology.- Virulence.- Pathogenesis.- Epidemiology.- Clinical Features.- Acute Gastroenteritis.- Typhoid (Enteric) Fever.- Septicemia with or without Localized Infection.- Asymptomatic Carrier State.- Complications.- Intestinal Perforation and Intestinal Hemorrhage.- Relapse.- Miscellaneous Complications.- Institutional Salmonellosis.- Conditions Predisposing to or Associated with Salmonellosis.- Salmonellosis and Hematologic Diseases.- Salmonellosis and Malignant Disorders.- Salmonella Bacteremia and Aneurysm of the Aorta.- Salmonellosis and Schistosomiasis.- Salmonellosis and Ulcerative Colitis.- Diagnosis.- Nontyphoid Salmonella Infection.- Typhoid Fever.- Antimicrobial Resistance among Salmonella Organisms: Relationship of Human and Animal Strains.- Antimicrobial Therapy.- Salmonella Gastroenteritis.- Typhoid (Enteric) Fever.- Typhoid Carriers.- Immunoprophylaxis.- Parenteral Typhoid Vaccines.- Oral Typhoid Vaccines.- References.- 6. Cholera and Escherichia coli Diarrhea.- Cholera.- Cholera Toxin.- Pathogenesis of Cholera.- Mechanism of Action of Cholera Toxin.- Cholera Immunity.- Antibacterial Immunity.- Antitoxic Immunity.- ETEC Diarrhea.- Enterotoxins of E. coli.- Purification of Enterotoxins.- Assays for E. coli Enterotoxin.- Pathogenesis of ETEC Diarrhea.- Relationships of CFA, Enterotoxin Production, and Serotype.- Virulence of CFA/I and CFA/II.- Mechanism of Action of E. coli Enterotoxin.- ETEC Immunity.- Enteropathogenic E. coli (by Serotype Identification).- Serotyping Procedures.- Relationship of E. coli Serotype and Pathogenicity.- References.- 7. Viral Agents in Diarrhea.- Norwalk-Like Agents.- Clinical Aspects.- Immunity.- Rotaviruses (RVs).- Antigenic Relationship of RVs.- RV Detection.- Pathogenesis of HRV Diarrhea.- Propagation of HRV.- Clinical, Epidemiologic, and Microbiologic Aspects of HRV Infection.- Serology of HRV Infection.- Immunity in HRV Infection.- References.- 8. Relative Importance of Enteropathogens in Acute Endemic Diarrhea and Food-Borne Diarrheal Illness.- Acute Endemic Diarrhea.- Rotavirus (RV).- Norwalk-Like Agents.- Enterotoxigenic E. coli (ETEC).- Serotype-Identified Enteropathogenic E. coli (EPEC).- Shigella.- Salmonella.- Multiple Enteropathogens.- The Remaining Forty Percent.- Other Toxin Producers.- Campylobacter.- Noncholera Vibrios and V. parahemolyticus.- Yersinia Enterocolitica.- Food-Borne Diarrheal Illness.- References.- 9. Diarrhea of Travelers (Emporiatric Enteritis).- Magnitude of the Problem and Populations at Risk.- Clinical Aspects.- Etiology.- Prevention of Travelers' Diarrhea and the Source of the Problem.- References.- 10. Diagnosis and Treatment of Acute Diarrhea.- Diagnostic Procedures.- Fecal Leukocytes.- Serotyping of E. coli.- Stool Culture.- Invasion of Intestinal Mucosa.- Toxin Detection Assays.- Ova and Parasites.- Virus Detection.- Nonspecific Therapy-Antidiarrheal Compounds.- Drugs That Alter Intestinal Motility.- Adsorbents.- Agents That Influence Intestinal Flora.- Agents That Inhibit Intestinal Secretion.- Specific Antimicrobial Therapy.- General.- Shigella.- Salmonella.- Miscellaneous Bacterial Agents.- Protozoal Agents.- References.- 11. Fluid and Dietary Management of Acute Diarrhea.- Mechanisms of Fluid and Electrolyte Loss by Causative Agent.- Fluid and Electrolyte Therapy.- Oral Rehydration.- Intravenous Rehydration.- Initiation of a Modified Diet.- Renal Solute Load.- Osmolarity.- Carbohydrate Activity in the Gastrointestinal Tract.- Composition of Standard and Soy Formulas.- Disaccharidase Deficiency.- Diagnosis of Carbohydrate Malabsorption.- References.