Clinical features of infantile diarrhea associated with single or multiple enteric pathogens

Clinical features of infantile diarrhea were studied among 603 infants from birth to 12 months of age to determine the predominant clinical feature(s) seen in infantile diarrhea associated with a specific enteric pathogen. Among the major clinical features, fever was most often seen in diarrhea due to Yersinia spp. (61.5%) followed by that in rotavirus (26.1%). Vomiting was mostly associated with Vibrio cholerae infection (90.9%) and shigellosis (64.6%). Dehydration was predominant in Vibrio cholerae (90.9%) and Salmonella (84.9%) infections. Bloody diarrhea was mostly due to Shigella infection (74.3%). As regards diarrhea with multiple pathogens, vomiting and dehydration were most frequent with Campylobacter+Enteropathogenic Escherichia coli (EPEC) (88.9% and 77.8%, respectively), while fever was more common with rotavirus+Shigella+Escherichia coli and rotavirus+Giardia. Infection with invasive organisms lead to vomiting, 4-10 stools per day and dehydration significantly more often as compared to infections with non-invasive organisms. Similarly more stools of patients infected with invasive organisms showed presence of blood and more than 5 leukocytes/HPF as compared to those infected with non-invasive organisms.