Gastrointestinale Infektionen – Differenzialdiagnose und Management für den Hausarzt

Gastrointestinale Infektionen mit enteropathogenen Viren sind besonders bei Kindern und älteren Menschen sehr häufig und können bei dieser Risikogruppe zu erheblichen klinischen Problemen führen. Insbesondere die Infektion mit Noroviren hat in den letzten Jahren sehr stark zugenommen und war im Jahr 2007 die häufigste meldepflichtige Erkrankung überhaupt. Darüber hinaus wird eine Zunahme der Clostridien difficile assoziierten Diarrhö registriert, die insbesondere ältere Menschen gefährdet. Enteritische Infektionen manifestieren sich klinisch in der Regel durch Diarrhö, manchmal in Kombination mit Erbrechen und Fieber. Als Erreger für diese Erkrankungen kommen eine Reihe von Viren, und Bakterien in Frage. Aufgrund der Fülle von verschiedenen Erregern, der Zunahme an neu beschriebenen Pathogenen und der Entwicklung von Resistenzen ist die Behandlung der gastrointestinalen Infektionen äußerst komplex, hat aber in erster Linie eine Flüssigkeits- und Elektrolytsubstitution zum Ziel.

Gastrointestinal infections with enteropathogenic viruses are very frequent especially in children and elderly patients. Considerable clinical problems may arise in patients of these risk groups. In particular, the incidence of infections with noroviruses has increased formidably in recent years. In fact, in 2007 these infections were the most frequent of all notifiable diseases. Over and above this, there has been an increase in diarrhoeas associated with Clostridium difficile which are particularly hazardous in the elderly. As a rule, enteritic infections are clinically manifested by diarrhoea, occasionally in association with vomiting and fever. Several strains of viruses and bacteria are held responsible for triggering these diseases. The treatment of gastrointestinal infections has become highly complex due to a plethora of different pathogens, the increase in newly arisen pathogens and the development of resistances. The primary target of such treatment, however, is the substitution of liquids and electrolytes.

Key words

Infectious diarrhoea - Clostridium difficile - pseudomembranous colitis - noroviruses - vaccine against rotaviruses - enteric campylobacteriosis - Salmonella

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