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Gordon RJ et al Bacterial infections in drug users N Engl J Med 2005 Nov 3;353(18):1945 54 [PMID: 16267325] Infections in injection drug users (entire issue) Infect Dis Clin North Am 2002 Sep;16(3)

An invoice list has header and item data You cannot change the details of the invoices once they are in the invoice list For invoice lists to be used, the following prerequisites must be maintained: An invoice list type must be assigned to each billing type that you want to use to process invoice lists The two invoice lists that may be used are LR and LG Should you need an additional billing document type for invoice lists, copy the original and rename it beginning with a Z Select Assign Invoice List Type to Each Billing Type Here you assign the invoice list type to be used by the associated billing document types, as seen in Figure 7-11 Copying control requirements must be maintained between the billing document and the invoice list document The system does not carry out copying at item level for billing documents The Standard copying control requirement used in invoice lists is 016

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Cyclospora, cryptosporidia, and Isospora are protozoans capable of causing disease in both immunocompetent and immunocompromised patients Characteristics of disease include profuse watery diarrhea that is prolonged but usually selflimited (1 2 weeks) in the immunocompetent patient but can be chronic in the compromised host Epidemiologic features may be helpful in determining etiology Recent hospitalization or antibiotic use suggests C difficile; recent foreign travel suggests Salmonella, Shigella, Campylobacter, E coli, or V cholerae; undercooked hamburger suggests E coli, especially O157:H7; and fried rice consumption is associated with B cereus toxin Prominent features of some of these causes of diarrhea are listed in Table 30 3

Diarrhea is acute if lasts < 2 weeks and chronic if lasts > 2 weeks Disease is mild if there are three or fewer stools per day, moderate if there are four or more stools in association with local symptoms (abdominal cramps, nausea, tenesmus), and severe if there are four or more stools per day with systemic symptoms (fevers, chills, dehydration)

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Acute diarrhea can be caused by a number of different factors, including emotional stress, food intolerance, inorganic agents (eg, sodium nitrite), organic substances (eg, mushrooms, shellfish), drugs, and infectious agents (including viruses, bacteria, and protozoa) From a diagnostic and therapeutic standpoint, it is helpful to classify infectious diarrhea into syndromes that produce inflammatory or bloody diarrhea and those that are noninflammatory, nonbloody, or watery In general, the term inflammatory diarrhea suggests colonic involvement by invasive bacteria or parasites or by toxin production Patients complain of frequent bloody, smallvolume stools, often associated with fever, abdominal cramps, tenesmus, and fecal urgency Common causes of this syndrome include Shigella, Salmonella, Campylobacter, Yersinia, invasive strains of Escherichia coli, E coli O157:H7, Entamoeba histolytica, and C difficile Tests for fecal leukocytes or the neutrophil marker lactoferrin are frequently positive, and definitive etiologic diagnosis requires stool culture Noninflammatory diarrhea is generally milder and is caused by viruses or toxins that affect the small intestine and interfere with salt and water balance, resulting in large-volume watery diarrhea, often with nausea, vomiting, and cramps Common causes of this syndrome include viruses (eg, rotavirus, Norwalk virus, enteric adenoviruses, astrovirus, coronavirus), vibriones (Vibrio cholerae, Vibrio parahaemolyticus), enterotoxin-producing E coli, Giardia lamblia, cryptosporidia, and agents that can cause food-borne gastroenteritis The term food poisoning denotes diseases caused by toxins present in consumed foods When the incubation period is short (1 6 hours after consumption), the toxin is usually preformed Vomiting is usually a major complaint, and fever is usually absent Examples include intoxication from S aureus or Bacillus cereus, and toxin can be detected in the food When the incubation period is longer between 8 hours and 16 hours the organism is present in the food and produces toxin after being ingested Vomiting is less prominent, abdominal cramping is frequent, and fever is often absent The best example of this disease is that due to Clostridium perfringens Toxin can be detected in food or stool specimens The inflammatory and noninflammatory diarrheas discussed above can also be transmitted by food and water and usually have incubation periods between 12 and 72 hours.

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