• Severe end-organ involvement: • Hepatic transaminases >1,000 IU/L • Impaired consciousness • End-organ failure e-TABLE 94.20 INFLAMMATORY VERSUS NONINFLAMMATORY DIARRHEA Mechanism Symptoms Stool quality Anatomic site Pathogens Inflammatory Noninflammatory Destruction of enteric mucous membranes resulting in inflammatory response Release of neutrophils and erythrocytes in stool Abdominal pain, fever, tenesmus Small volume, frequent, blood and mucus present Distal ileum and colon Enteroinvasive E coli Enterohemorrhagic E coli Campylobacter spp Salmonella spp Shigella spp Clostridium difficile Entamoeba histolytica Osmotic: inability to breakdown disaccharides Secretory: intestinal epithelial cells are stimulated to secrete fluid Abdominal pain, nausea, vomiting Large volume, watery stool Proximal small intestine Enterotoxigenic E coli Vibrio cholera Campylobacter spp Salmonella spp Bacillis cereus Cryptosporidium hominis Giardia intestinalis