EPIDEMIOLOGICAL AND CLINICAL-PATHOGENETIC ASPECTS OF DIFFERENTIAL DIAGNOSIS OF ACUTE INTESTINAL INFECTIONS IN ADULTS

Abstract

The incidence of acute intestinal infections in the Russian Federation remains high and does not tend to decrease. The General susceptibility of the population, the variety of pathogens of infectious diseases accompanied by diarrhea syndrome, necessitates the improvement of clinical diagnosis and differential diagnosis in the treatment of patients with diarrhea at the primary stage of medical care. The article presents the etiological and epidemiological aspects of the most common in the Russian Federation acute intestinal infectious diseases accompanied by diarrhea syndrome: food toxicoinfections, viral gastroenteritis, salmonellosis, shigellosis, campylobacteriosis, pseudomembranous colitis. The sources of infection and pathways of pathogens are characterized. The pathogenesis of the main types of diarrhea caused by various pathogens of intestinal infections is described. It is shown that the action of enterotoxins of pathogens that activate adenylate cyclase contributes to the development of secretory type of diarrhea; the place of localization of the pathological process is the small intestine. Pathogens exhibiting high invasive activity contribute to the development of inflammatory type of diarrhea; the pathological process is localized in the colon. With direct damage to enterocytes of the small intestine by pathogens of viral gastroenteritis, an osmotic type of diarrhea is formed, associated with a violation of the digesting and absorption function of the small intestine. Presented distinctive clinical criteria of three types of diarrhea: color, consistency of the stool, the presence of pathological impurities in it. The differences of abdominal syndrome in the analyzed nosology: the nature and localization of abdominal pain. The presented differential diagnostic signs of diarrhea and abdominal syndrome allow for early diagnosis of infectious disease before laboratory confirmation and contribute to the improvement of the algorithm of medical care in acute intestinal infections accompanied by diarrhea syndrome.