State-of-the-Art Review: Infectious Diarrhea

Abstract

In this review, we describe a multidisciplinary approach to the care of a patient with diarrhea, known or suspected to be the result of an infection, incorporating infectious disease, gastroenterology, microbiology, and pharmacy clinical perspectives. We highlight updates in the epidemiology and etiologies of infectious diarrhea, considering both the individual and community impact of disease burden since the publication of the 2017 Infectious Diseases Society of America endorsed guidelines addressing the management of infectious diarrhea. We consider the acute, chronic, and post-infectious intestinal and extra-intestinal manifestations of infectious diarrhea and the clinical challenges posed by each. We discuss the role of diagnostics, including molecular-based testing, often referred to as culture independent diagnostic testing, and culture-based platforms and their role in clinical care and public health surveillance. We discuss emerging antimicrobial resistance and the role of biotherapeutics as strategies to decrease the burden of infectious diarrhea.