17-6 -- Infectious Enterocolitis Flashcards
What are the reservoirs for Vibrio Cholerae?
Fish and Plankton
Transmission for Vibrio Cholerae?
Contaminated water
Pathogenesis for Vibrio Cholerae?
- Bacteria releases Cholera Toxin
- Toxin causes CFTR channel to open
- Cl-, bicarbonate and Na+ accumulate in lumen
= Draws water into lumen
Symptoms of Vibrio Cholerae?
Rice water, fishy odor diarrhea
The Cholera toxin causes what channel to open?
CFTR = Cl- allowed into lumen
Ingestion of _____ causes Campylobacter Jejuni
Undercooked chicken
Unpasteurized milk and contaminated water
Campylobacter Jejuni virulence is due to what 4 things?
Motility
Adherence
Toxin production
Invasion
Campylobacter Jejuni symptoms?
Bloody diarrhea, Enteric fever
Reactive Arthritis, Erythema Nodosum
Guillain-Barre Syndrome
Campylobacter Jejuni can cause Reactive Arthritis is those with what HLA?
HLA-B27
What main syndrome/symptoms are seen with Campylobacter Jejuni?
Guillain - Barre Syndrome
= Ascending flaccid paralysis
Guillain - Barre Syndrome = Ascending flaccid paralysis is seen with?
Campylobacter Jejuni
Reservoir for Shigella and transmission type?
Reservoir = humans Transmission = fecal - oral; contaminated food/water
Where is Shigella infection common?
Daycares, nursing homes, low resource countries and migrant workers
Shigella is resistant to gastric acid. What cells does it infiltrate and proliferate in?
M cells
Shigella enters M cells. Where anatomically, is that often located?
Left colon
- M cells in dome epithelium
Shigella causes apoptosis of?
Macrophages
Symptoms of Shigella?
Bloody diarrhea, aphthous ulcers
- can mimic ulcerative colitis with waxing and waning diarrhea
The severity of symptoms for Shigella is greater in?
Children
In those with Shigella, what should you NOT give them?
Antidiarrheal - prolongs infection
Possible complications of Shigella?
Megacolon (left colon)
Hemolytic Uremic Syndrome
Reactive Arthritis
What infection can mimic ulcerative colitis with waxing and waning bloody diarrhea?
Shigella
Salmonella arises from ingestion of ____ or from?
Ingestion of undercooked meat
From person to person
Salmonella can occur more frequently in those with decreased?
Gastric acid production
3 types of Salmonella strains and what they are common in/cause?
S. Paratyphi - travelers
S. typhi - typhoid fever
S. enteritidis - gastroenteritis and food poisoning
Where can S. Paratyphi and S. Typhi colonize?
Gallbladder = Gallstones and chronic carrier
Chronic carrier of S. Typhi (typhoid fever) has S. typhi colonized where?
Gallbladder
If Typhoid fever disseminates via lymph and blood, what can it cause?
Meningitis, seizures, endocarditis, etc.
What morphologic (3) changes are seen with Typhoid Fever?
Enlarged peyers patches
Enlarged spleen
Typhoid nodules on liver
– (macrophages replace hepatocytes)
Skin symptoms of Typhoid Fever/Salmonella?
Rose spots on the skin
Yersinia can arise from ingestion of?
Pork, raw milk, contaminated water
With Yersinia, what can increase its virulence?
IRON
Those with chronic forms of ____ are at greater risk for sepsis and death from Yersinia
= Anemia and Hemochromatosis
IRON ISSUES
What can often be confused with Crohn Disease?
Yersinia
Symptoms of Yersinia?
Nausea, vomiting
Pharyngitis, arthralgia and erythema nodosum
What 3 things can increase risks of Clostridiodes Difficile overgrowth?
Antibiotics
Increased age
Hospitalizations
What main thing does Clostridiodes Difficile cause?
Pseudomembranous Colitis
What main thing does Clostridiodes Difficile cause?
Pseudomembranous Colitis
Symptoms of Pseudomembranous Colitis (from C. Difficile)?
Fever, Leukocytosis
Cramps, watery diarrhea
Toxic megacolon
What can be common in farmers with exposure to soil/animals?
Tropheryma Whippelli
whipple disease
Tropheryma Whippelli involves impaired?
Lymph drainage
What molecular changes are seen with Tropheryma Whippelli?
Foamy macrophages in SI lamina propria
– Contain PAS (+) granules
Foamy macrophages with PAS (+) granules are seen with?
Tropheryma Whippelli
Triad of symptoms for Tropheryma Whippelli?
Malabsorptive diarrhea
Weight loss
Arthralgia
Triad of symptoms of Tropheryma Whippelli?
Malabsorptive diarrhea
Weight loss
Arthralgia
2 common viruses that cause gastroenteritis?
Norovirus
Rotavirus - common in children 6-24 months