Diarrhoea Flashcards
Acute food poisoning
Sudden onset of nausea, vomiting and diarrhoea after the ingestion of a toxin. Staphylococcus aureus, Bacillus cereus or Clostridium perfringens.
Escherichia coli
Common amongst travellers Watery stools Abdominal cramps and nausea
Giardiasis
GIardia lamblia a flagellate protozoan. Spread via F-O route. Often asymptomatic. Lethargy, bloating. Prolonged, non-bloody diarrhoea. Chronic diarrhoea, malabsorption and lactose intolerance can occur. Tx: metronidazole
Cholera
Profuse, watery diarrhoea Severe dehydration resulting in weight loss Not common amongst travellers
Shigella
Bloody diarrhoea Vomiting and abdominal pain
Staphylococcus aureus
Severe vomiting Short incubation period
Campylobacter
A flu-like prodrome is usually followed by crampy abdominal pains, fever and diarrhoea which may be bloody May mimic appendicitis Complications include Guillain-Barre syndrome
Bacillus cereus
Two types of illness are seen vomiting within 6 hours, stereotypically due to rice diarrhoeal illness occurring after 6 hours
Amoebiasis
Gradual onset bloody diarrhoea, abdominal pain and tenderness which may last for several weeks
Incubation period
1-6 hrs: Staphylococcus aureus, Bacillus cereus* 12-48 hrs: Salmonella, Escherichia coli 48-72 hrs: Shigella, Campylobacter > 7 days: Giardiasis, Amoebiasis
5 features of hypervirulent C. diff + strain name
- Produces binary toxin - always absent in other C.diff strains
- Produces more A and B toxins
- Has partial deletion of tcDc
- Resistant to fluoroquinolones
- Associated with severe disease and severe outcomes - including increased mortality
Pathogens of Travellers’ Diarrhoea
Most common cause = Enterotoxigenic Escherichia coli (ETEC)
Asia = Salmonella and Campylobacter increasing importance
Cruise ships = Norovirus
