Akut Gastroenteritler
Özet
Akut gastroenteritler (AGE), özellikle içme suları ve gıdalar yoluyla bulaşan, tüm dünyada yaygın olarak görülen enfeksiyöz enfeksiyonlardır. Gelişmekte olan ülkelerde çocuklarda malnütrisyon ve ölüm nedeniyken, gelişmiş ülkelerde ise yaşlılar ile immün sistemi baskılanmış bireylerde ağır seyretmektedir. Hastalığın en sık nedenleri virüsler (rotavirüs, norovirüs) ve bakterilerdir (ETEC, Shigella, Salmonella, Campylobacter). Klinik tablo mide ve ince bağırsağın tutulumu ile karakterize olup; bulantı, kusma, karın ağrısı ve 24 saat içinde üçten fazla sulu dışkılama ile kendini gösterir. Tanı koyulurken hastanın anamnezi, dehidratasyon durumu, dışkının makroskobik ve mikroskobik (lökosit, parazit kistleri) incelemeleri ile antijen testleri ve dışkı kültürü önem taşır. Tedavinin temelini sıvı ve elektrolit kaybının oral veya intravenöz hidrasyonla yerine konulması oluşturur. Vakaların büyük çoğunluğu antimikrobiyal tedaviye ihtiyaç duymadan iyileşirken, antibiyotik kullanımı şigelloz, kolera ve amebiyazis gibi spesifik endikasyonlar dahilinde vakaların sadece yaklaşık yüzde onunda gereklidir.
Acute gastroenteritis (AGE) is a common infectious disease worldwide, primarily transmitted through contaminated drinking water and food. In developing countries, it causes malnutrition and mortality in children, whereas in developed countries, it progresses severely in the elderly and immunocompromised individuals. The most common etiologies are viruses (rotavirus, norovirus) and bacteria (ETEC, Shigella, Salmonella, Campylobacter). The clinical presentation involves the stomach and small intestine, characterized by nausea, vomiting, abdominal pain, and three or more loose stools within 24 hours. Diagnosis relies on patient history, dehydration status, macroscopic and microscopic evaluation of stool (leukocytes, parasite cysts), antigen testing, and stool cultures. The cornerstone of treatment is replacing fluid and electrolyte losses through oral or intravenous hydration. While most cases resolve without antimicrobial therapy, antibiotic treatment is necessary in only about ten percent of cases, including specific indications such as shigellosis, cholera, and amebiasis.
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