[Acute infectious diarrhea in adults]

Acute infectious diarrhoea are common and usually self-limited but their management is often inadequate due to over-prescriptions of stool cultures and antibiotics. From a clinical point of view, the most important point is to promptly identify presentations at risk of complications (severe dehydration, septic shock, surgical complications) such as elderly patients, co-morbidity, diabetes, renal or heart deficiency, immune deficiency...). When the epidemiological context is suggestive, physicians have to systematically consider certain clinical forms potentially at risk of severe outcome: collective food poisoning, E. coli O157:H7 bloody diarrhoea with the risk of hemolytic-uremic syndrome or antibiotic-associated pseudomembranous colitis due to Clostridium difficile. Rehydration, including Na, K and glucose, remains the corner stone of the treatment, symptomatic medications being of limited interest and antibiotics reserved to presentations at risk of complications.