"Viral Intestinal Infections. Differential Diagnosis from Bacterial Infections"

Introduction: Acute intestinal infections represent one of the most common causes of morbidity worldwide, affecting individuals of all ages but particularly infants, young children, and the elderly. Diarrhea, vomiting, abdominal pain, and fever are all common clinical signs of these infections, which are mostly caused by a variety of viral and bacterial pathogens. It can be difficult to tell the difference between viral and bacterial causes because of this overlap, but doing so is essential for effective infection control and management. Viral gastroenteritis—caused predominantly by rotavirus, norovirus, adenovirus, and astrovirus—is typically self-limiting and characterized by watery diarrhea and vomiting resulting from damage to intestinal epithelial cells and transient malabsorption. In contrast, bacterial intestinal infections—caused by organisms such as Salmonella, Shigella, Escherichia coli, Campylobacter, and Vibrio species—may involve toxin production or direct mucosal invasion, often leading to inflammatory or bloody diarrhea, systemic toxicity, and potential complications. Accurate differentiation between viral and bacterial intestinal infections is essential to guide treatment decisions, prevent unnecessary antibiotic use, and reduce the risk of antimicrobial resistance. This article reviews the epidemiology, pathogenesis, and clinical features of viral intestinal infections and highlights the key clinical, laboratory, and epidemiological features that aid in their differential diagnosis from bacterial infections.