Diarrheal Illnesses Flashcards
Acute Diarrhea first assessment?
Mild to moderate dehydration = ORT
Severe Dehydration = IV Hydration (Esp Elderly)
1, #2 and #3 causes of foodborne illness?
1 Norovirus
Examples of Enteric Infections ?
- Campylobactor jejuni
- Salmonellosis
- Shigellosis
Whats the best way to Dx diarrheal illnesses?
Good Pt history
What does a PE for diarrhea consist of?
- Vitals
- Skin Turgor
Peritoneal signs
- Orthostatic hypotension
What is the leading cause of acute diarrhea and Systemic illness world wide ?
Campylobactor jejuni bacteria
Campylobactor jejuni bacteria can be transmitted by?
- Raw/ Under cooked poultry
- Food contaminated by raw or under cooked poultry
- Unpasteurized dairy products, contaminated water, or produce
- Contact with the feces of a dog or cat
What is the peak incidence time frame and demographic affected by Campylobactor jejuni bacteria?
Summer months
Early childhood
Early Adulthood
Males > Females
Earliest S&S of Campylobactor jejuni bacteria infection?
- Abrupt onset
- Ab pain & Diarrhea
- 33% of Pt’s can have a Prodromal period (Sign that the diseases will be much worse)
Acute Illness of Campylobactor disease includes?
- 10 plus bowel movements
- Bloody stools (Day 2 or 3)
- Nausea very common
Population at higher risk of severe disease with Campylobactor?
- Elderly
- Immunocompromised (HIV)
What are some local complications (rare) of Campylobactor disease?
Pseduoappendicitis
Colitis
What are some late onset systemic complications of Campylobactor jejuni disease?
- Guilian Barre Syndrome (40% of pt’s)
- Reactive Arthritis (Self limiting, seen in Pt’s with HLA-B27 antigens)
How do you Dx Campylobactor jejuni disease?
- Stool culture
- Usually self limiting
- Maintain Hydration and Electrolytes
When do you treat with antibiotics for Campylobactor jejuni disease?
Pt’s with severe disease
- Bloody stools
- High fever (>101.5 F)
- Extraintestinal infection
- Worsening or relapsing symptoms
- Symptoms > 1 week
- Infants
- Elderly
- Pregnant
- Immunocompromised
Antibiotic Tx for severe Campylobactor jejuni disease?
- 7 to 10 days
- Azithromycin
- Erythromycin
NOT to be given if patient on a drug that inhibits CYP3A4
What antibitoics is Campylobactor jejuni resistant to?
- Quinolones
- Ampicillin
- Amoxicillin
- Cephalosporins
Salmonella most commonly transmitted by?
- Food products contaminated with animal products or waste
- Eggs and Poultry MC
- Undercooked meat
- Unpasteurized dairy
- Seafood
- Fresh produce
Major cause of food borne illness in US?
- Chicken eggs infected with Salmonalla Entertitdis
- Cook eggs until yolk is solidified
Other sources of transmission of salmonella?
- Processed foods
- Fresh veggies and fruit contaminated by manure
- Reptiles
Fecal carriage up to 90%
What are the two type of Salmonella?
- Typhoidal
- Non Typhoidal (more common)
What is another name for typhodial salmonella?
Enteric fever
- Salmonella typhi (S. typhi)
- Salmonella paratyphi (S.paratyphi)
How is enteric fever transmitted?
-Close contact Acutely infected individual
or
- Chronic carrier
- Most cases ingestion of contaminated food
Two most common strains of Non-Typhodial salmonella?
S. typhimurium
S. entertitdis
