CA - GI infections, ENT (CKL) Wk 2 Flashcards
Whats the Reservoir/Mode of transmission of the Salmonella species
(S enteriditis – commonest)?
Food
Whats the treatment for Salmonella species (S enteriditis – commonest)?
Usually self-limiting
Whats the Reservoir/Mode of transmission of the Salmonella typhi (‘typhoid fever’)
Salmonella paratyphi
- Water-borne
- Person to person (ingestion of food & water contaminated by faeces/urine of patients or carriers –> check for stool clearance)
Whats the treatment for Salmonella typhi (typhoid fever) and Salmonella paratyphi?
- Must be treated with antibiotics
- Patient at risk of sepsis or seeding/spreading of infection if not treated
- imported infection
Whats the Reservoir/Mode of transmission of the Shigella species?
Person to person
Whats the treatment for Shigella species?
Usually self-limiting, maintain good hydration
Whats the Reservoir/Mode of transmission of Campylobacter jejuni?
Food - chicken!
Whats the treatment for Campylobacter jejuni?
Usually self-limiting
Whats the Reservoir/Mode of transmission of the Vibrio species?
Food - raw seafood / sushi
Whats the treatment for Vibrio species?
Usually self-limiting
Whats the Reservoir/Mode of transmission of clostridium difficile?
- Antibiotic over-exposure -> person to person
- abx kills good bacteria -> no more good bacteria to compete with c-diff for nutrients & space -> c-diff will multiply & release toxins - Contaminated hospital environment
Whats the treatment for clostridium difficile?
What are its complications?
- Needs treatment.
- Can lead to colitis, toxin megacolon - extreme dilation of colon -> cant pass stools / gas + buildup of toxic contents -> septic shock -> DEATH!
Which is the most infectious virus that causes GI infections?
Norovirus!!!
Whats the Reservoir/Mode of transmission of Norovirus? What is it known to cause in hospitals?
- Contaminated food (Shellfish) / water ->
human -> rapid human to human spread via fecal-oral or even objects - Usually seen in hospitals, nursing homes, cruises
- Well known cause of uncontrolled diarrhoea -> ward closure
Whats the Reservoir/Mode of transmission of Rotavirus & Adenovirus?
Person to person
What does the rotavirus & adenovirus most commonly cause?
Paediatric diarrhoea
Whats the treatment for norovirus, rotavirus & adenovirus?
Self-limiting
What test sample to send for these organisms? How long does it take?
- Salmonella species (typhi & parathyphi)
- Shigella
- Campylobacter
- Vibrio (including cholera)
- Stool for C&S
- 24-48 hrs
What test sample to send for Clostridium Difficile?
Stool for C-diff toxins
- NO MC&S - difficult to grow
What test sample to send for Norovirus, Rotavirus & Adenovirus?
Stool for
1. EIA – enzyme immunoassay (another viral test)
2. or PCR
What test sample to send for parasites?
Stool for microscopy OCP
- Ova, cysts, parasites
Whats OCP?
- Ova, cysts, parasites
- a form of microscopy
- no C&S bcs very difficult to grow
What pathogens cause peritonitis infections like perforation of organs within
the abdomen & Spontaneous bacterial peritonitis?
Commensal bacteria from intestines:
1. Coliforms
2. Pseudomonas aeruginosa
3. Anaerobes
4. Enterococci
5. Candida (a type of yeast)
What pathogens cause peritonitis associated with peritoneal dialysis?
Commensal bacteria from intestines:
1. Coliforms
2. Pseudomonas aeruginosa
3. Anaerobes
4. Enterococci
5. Candida (a type of yeast)
AND
- Members of skin flora (usually Coag
neg Staphylococcus) - Staph aureus
- Other environmental bacteria
(because of the plastic tube!)
What are the 2 most common pathogens that causes pharyngitis?
- Viruses
- Rhinovirus (common cold), Epstein–Barr virus EBV, Cytomegalovirus CMV, Enterovirus, Adenovirus, Parainfluenza - Grp A Streptococcus
What’s the treatment of Grp A Strep Infection?
ABX
What are the complications after Group A Strep infections?
What treatment is used to prevent rheumatic fever?
- Rheumatic fever
- Rheumatic heart disease
- Glomerulonephritis
Prevent rheumatic fever:
- abx prophylaxis
What is Corynebacterium diphtheriae? What are the symptoms and complications of this infection?
- Acute bacterial infection: tonsils, pharynx, larynx, skin
Symptoms:
1. Malaise, sore throat, fever, lymphadenopathy.
2. Thick adherent pseudomembrane present on one or both tonsils.
3. Airway obstruction
Complications
1. Toxin produced -> arrhythmia, myocarditis, heart block
2. Paralysis, Guillain-Barre-like syndrome - tingling, numbness
Whats the mode of transmission of Corynebacterium diphtheriae?
– contact with infectious patient’s respiratory droplets, open skin wound, clothing/toys contaminated with the bacteria
When does the infectious period for Corynebacterium diphtheriae infection end?
– until bacteria are no longer identified from throat swab/skin lesion
- After 14 days of effective antibiotic therapy
What symptoms do toxigenic and non-toxigenic strains of Corynebacterium diphtheriae cause?
Toxigenic strains:
- pseudomembrane & nerve toxicity
Non-toxigenic strains: causes inflammation
- colonise airway
- pharyngitis but grp a strep & viruses causing are more common
- cutaneous abscess: pus-filled lump in the skin
- systemic infections
How to diagnose Corynebacterium diphtheriae?
- culture of clinical specimen (throat or nasopharyngeal swab)
- NO Microscopy bcs its a bacteria
How to prevent Corynebacterium diphtheriae?
- Vaccination
- Antibiotic prophylaxis of close contacts
What are the 2 most common bacterias associated with sinusitis?
Streptococcus pneumoniae
Haemophilus influenzae
Whats conjunctivitis & is bacterial or viral infection more common?
- red eyes
- viral more common, affects both eyes
