BBL: Case 3

Question 1

Anatomical regions of the GI tracts

Answer 1

• Esophagus
• Stomach (Few bacteria because of decreased pH)
• Small intestine (Duodemnum, Jejunum, Ileum)
• Large intestine
• Colon (Caecum, ascending, transverse, descending)
• Sigmoid
• Rectum

Question 2

Clinical signs of dehydration

Answer 2

• Sunken eyes
• dry mouth
• decrease in urine
• “tenting” of skin
• orthostatic hypotension (and fainting)
• kidney failure

Question 3

Campylobacter

• source
• disease?

Answer 3

• Food (especially chicken)

- Guillen-Barre

Question 4

Salmonella

- source

Answer 4

Food: Chicken, Reptiles (iguanas and turtles), birds

Question 5

Shigella

- source

Answer 5

person to person especially in daycare centers; fecal oral; low infecting dose (ID-50 = # organisms takes to infect 50% of people) Very low ID50

Question 6

Vibrio

• source
• Disease

Answer 6

• Shellfish, salt water

- agent of Cholera; rice water stools; see Cholera after flood/disasters

Question 7

V. parahaemolyticus

• source
• disease

Answer 7

sea food, most common in the US (because we eat shellfish)

Question 8

V. vulnificus

• source
• disease

Answer 8

Raw oysters

- causes septicemia more often

Question 9

Clostridium difficile

• source
• disease

Answer 9

• antibiotic associated; found a lot in the hospitals (nosocomial); normal flora but can be bad
• Pseudomembraneous colitis

Question 10

Yersinia enterocolicia

• source
• disease

Answer 10

• meats and dairy products; able to grow at 4C - appendicitis-like illness (kids get appendix out but find out it was not causing the problem!)

Question 11

Helicobacter pylori

• source
• disease

Answer 11

• oral to oral/fecal oral

- peptic ulcers

Question 12

Plesiomonas and Aeromonas

Answer 12

both cause gastroenteritis, unusual fermenting GNR’s; Oxidase positive

Question 13

S. aureus

- source

Answer 13

picnics

Question 14

C. botulinum

Answer 14

canned foods and honey (infants)

Question 15

Bacillus Cereus

Answer 15

Fried Rice

Question 16

Clostridium Perfringens

Answer 16

(big anaerobe) meat and gravy

Question 17

Salmonella Typhi

• source
• disease

Answer 17

• humans only known host

- Typhoid fever (Enteric fever)

Question 18

Most common aerobe in the GI?

Answer 18

E. coli

Question 19

Enteropathogenic E. coli (EPEC)

Answer 19

• infant diarrhea (developing countries)

- non-invasive (non-bloody diarrhea)

Question 20

Enterotoxigenic E. coli (ETEC)

• Other names?
• Do we grow it in culture?

Answer 20

• Traveler’s Diarrhea (Montezuma’s Revenge)
• Self-limiting
• Do not grow in culture

Question 21

Enteroinvasive E. coli (EIEC)

• Descrive its invasiveness
• Do we culture it?

Answer 21

• Similar to Shigella: invades into mucosal cells of intestine…not through to blood
• No culture

Question 22

Enterohemorrhagic E. coli (EHEC)

• other names?
• pathogenicity?
• Diseases
• Do we culture?

Answer 22

• Shiga toxin (STEC); Verotoxin (VTEC)
• pathogenicity comes from cytotoxins
• Hemorrhagic colitis; Hemolytic-uremic Syndrome (HUS)
• ??? Culture or Shiga toxin testing to identify

Question 23

What is the leading cause of acute renal failure in children?

Answer 23

HUS

Question 24

Should you treat EHEC (STEC/VTEC) with antibiotics?

Answer 24

NO! avoid treatment with antibiotics because it releases the toxin

Question 25

Enterohemorrhagic E. coli (EHEC/STEC/VTEC)

- source of infection

Answer 25

• Major: hamburger

- fruits, vegetables, water

Question 26

Two organisms that invade into the mucosa?

Answer 26

***Salmonella and EIEC

Question 27

Two organisms that invade into the blood from the mucosa?

Answer 27

***Salmonella tiphi and Vibrio vulnificus