Infectious Disease Compendium

Diverticulosis/itis

Diagnosis

Abdominal pain, fevers. CT best diagnostic tool.

Epidemiologic Risks

Mid to old age.

Microbiology

Bowel flora Escherichia coli, anaerobes and streptococci.

Empiric Therapy

A third generation cephalosporins PLUS metronidazole is my fav for admissions,

For po therapy or beta lactam allergy would be a quinolone PLUS metronidazole OR tmp/sulfa PLUS metronidazole. Amoxicillin/clavulanate alone should be fine as well.

But antibiotics are no better than placebo for uncomplicated outpatient disease (PubMed)(PubMed)(Pubmed) and those who have supportive care have "no difference in readmission rates, treatment failure rates, progression to complicated diverticulitis, or increased need for elective or emergent surgery."

Specific Therapy

10 - 14 days total.

Pearls

If the tic perforates, laproscopic resection has worser (yes, worser) outcomes (PubMed).

Rants

Curious Cases

Relevant links to my Medscape blog

True?

Last Update: 06/23/18.