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DSA: Acute Infectious Diarrhea Flashcards

1
Q

Acute infectious diarrhea is the of the most infectious causes of death in the world. Most patients die due to ________.

A

Dehydration

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2
Q

Etiologies of acute infectious diarrhea and Sx

A
  1. Bacterial toxins or bacteria that make enterotoxins
    • => small bowel hypersecretion
      • Abrupt profuse watery diarrhea and vomitting a few hours after ingestion
      • Fever: minimal to none
  2. Entero-adherent pathogens
    • More cramping and bloating and less vomitting
    • Fever: high
  3. Invasive microorganisms that make cytotoxins
    • Fever: high
    • Abdominal pain
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3
Q

How will a pathogen that affects the small bowel persent?

A
  • Large amounts of watery diarrhea + cramps that can lead to dehydration and malabsorption.
    • Cramos occur in mid-abdomen or are diffuse
  • No WBC in stool (non-inflammatory)
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4
Q

How will a pathogen that affects the large bowel present?

A
  • Frequent, small amounts of bloody stool (dysentary) due to inflammation + fever and fecal leukocytes.
    • ​Location: lower abdomen or rectum
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5
Q
  1. Enterotoxins (non- inflammatory) pathogens affect the ____________, causing _____ diarrhea.
  2. Inflammatory (invasive or cytotoxins) pathogens affect the __________, causing ______ diarrhea.
  3. Penetrating pathogens affect the __________, causing _________.
A
  1. Proximal SB; watery
  2. Distal SB or colon; dysentary or inflammatory diarrhea
  3. Distal SB; enteric fever
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6
Q

What do we see in stool findings for these pathogens?

  1. Non-inflammatory (enterotoxins)
  2. Inflammatory (invasive or cytotoxin)
  3. Penetrating
A
  1. No fecal leukocytes; mild or NO increase in fecal lactoferrin
  2. Fecal PNM leukocytes; increase in fecal lactoferrin
  3. Fecal mononuclear leukocytes
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7
Q

2 Penetrating Pathogens

A
  1. Salmonella Typi
  2. Y. Enterocolitica
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8
Q

High risk groups for acute infectious diarrhea

A
  1. Travels
  2. Immunodeficient people
  3. Daycare workers/bbs/family
  4. Instutionalized ppl (nursing home, hospitals)
  5. Consuming certain foods
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9
Q

Daycare workers/ bbs and families are more susceptible to

A
  1. Shigella
  2. Giardia
  3. Crytosporidium
  4. Rotavirus
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10
Q

PE for patients with acute infectious diarrhea

A
  1. Fever, hypotension, tachycardia
  2. Dehydration
  3. Increased bowel sound
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11
Q

Decreased or absent bowel sounds =>

A
  1. Post-op ileus
  2. Toxic megacolon
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12
Q

Signs of mild, moderate and severe dehydration

A

Mild:

  • Thirst, dry mouth, ↓ sweat / urine output and slight weight loss

Moderate

  • Orthostatic fall in blood pressure, skin tenting, sunken eyes (infants = sunken fontanelle)

Severe:

  • Lethargy, obtundation, feeble pulse, hypotension, frank shock
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13
Q

Acute Infectious Diarrhea

  • ________ transmission and most cases are ________.
A
  • Fecal - oral transmission
  • Mild and self-limited, thus, does not need work-up
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14
Q

1st thing to do when a patient presents with acute diarrhea, no matter if mild, moderate or severe is to ___________.

A

Fluid and electrolyte replacement

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15
Q

In acute Infectious Diarrhea, diarrhea is self-limited and does not need workup. However, what are a few indications for work-ups?

A
    1. Profuse diarrhea (6 or more times a day) with dehydration
    1. Fever above 101 (38.5), hypotension and tachycardia that does not respond to volume repletion
    1. Dysentary (bloody diarrhea with leukocytes)
    1. Recent ABX uses (check for c.diff)
    1. Creatinine is more than 1.5x baseline or peripheral leukocytes is more than 15,000.
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16
Q

What do you perform upon workup of Acute Infectious Diarrhea?

A
  • CBC, electrolytes, BUN/Cr, blood culture
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17
Q

______ is the cornerstone of diagnosing Acute Infectious Diarrhea.

A

Stool culture

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18
Q

Routine bacterial stool culture tests for

A
  1. Salmonella
  2. Shigella
  3. E. coli
  4. Campylobactor (most)
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19
Q

What stool bacterial cultures must be requested?

A
  1. Shiga-like toxin detection for 0157:H7 EHEC (enterohemorrhagic e.coli)
  2. Vibrio
  3. Yersenia
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20
Q

What other labs may you need to ask for?

A
  1. Stool immunoassay PCR/toxin for C.diff
  2. Ova and parasites
  3. Stool protzoa antigen (giardia, cyrptosporidium, E. histolytica)
  4. Stool viral PCR/antigen (rotavirus, Norwalk/norovirus)
  5. Fecal leukocytes (inflammtory causes)
  6. Fecal lactoferrin (enzyme in leukocytes => inflammatory)
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21
Q

In Acute Infectious Diarrhea, if stool studies are unrevealing, perform a _________.

A

Endoscopy

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22
Q

Radiology requests for Acute Infectious Diarrhea

A
  • Abdominal XR (plain)
    • detects free intraperitoneal air and checks for ileus/toxic megacolon
  • Abdominal CT with PO/IV contrast
    • More sensitive for free air and IDs colitis
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23
Q
  • Suspect food poisening in a patient when:
  • Routine testing?
A
  • Multiple illnesses are reproted after sharing food and in the summertime
  • Routine testing is NOT done
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24
Q

Consumption of chicken is most associated with

A
  1. Salmonella
  2. Campylobacter
  3. Shigells
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25
Consumption of **undercooked hambuger** is most associated with
1. **Enterohemorrhagic E. coli (O157:H7)**
26
Consumption of **fried rice** is most associated with
1. Bacillus cereus
27
Consumption of **potato salad, mayo, cream pastries** is most associated with
1. **Staph. aureus**
28
Consumption of **eggs** is most associated with
1. **Salmonella**
29
Consumption of **lunch meats, uncooked foods or soft cheeses** is most associated with
1. **Listeria**
30
Consumption of **seafood** is most associated with
1. **Vibrio\*,** salmonella, acute HepA 2. Norwalk and campylobacter
31
**_Staph Aureus:_** * Micro * Clinical case * Treatment
* Micro * Gram (+) cocci (cluster of grapes) with preformed enterotoxins * Symptoms * **Rapid onset** (within 6 hours) of **watery diarrhea** and **N/V** after eating potato salad, mayo, cream pastries or eggs. * Treatment * Rapidly goes away (24-48 hours)
32
**_Bacillus Cerus_** * Micro * Clinical case * Treatment
* Micro * Gram (+) rod with preformed toxins * Symptoms * **Rapid onset (within 6 hours)** with **mainly vomitting** and may cause **watery diarrhea** after eating fried rice. * Treatment * Rapidly goes away (24-48 hours)
33
**Clostridium Perfringens** * Micro * Clinical case * Treatment
* Micro: * Gram (+) spore-forming rod with preformed enterotoxins * Heat resistant * Clinical case * Rapid onset (8-16) hours of watery diarrhea (no N/V) after eating large amounts of ham, beef, legumes, gravy (heat resistant spores) * Treatment * Rapidly goes away (24-28 hours)
34
**Shigella** * Micro * Clinical case * Treatment
* **Gram (-) rod** with enteroxin shiga toxin; non-motile * **Watery diarrhea** =\> intense colitis with **fever** and **dysentary (**small bowels with blood + pus) after eating **potato/egg salad, lettuce or raw veggies** * Treat: ABX and lasts 7 days
35
How do we **diagnose** Shigella toxin?
* **(+) fecal leukocytes** * Stool culture makes it hard to distinguish from **IBD**
36
Complications of **Shigella**
1. **Reative arthritis** (cant see, cant pee, cant climb a tree) * Conjunctivitis, uretheritis, arthritis 2. **HUS**
37
**_Salmonella typhimurium_** * Micro * Clinical case * Treatment
* Gram (-) rod; motile and non-lactose fermenting that penetrates SI mucosa via M-cells over Peyers patches * Watery diarrhea =\> bloody diarrhea + fever, N/V after * Eating **eggs/poultry,** * Expsure to reptiles (turtles), ducks, birds * Treatment * Self limited (5-10 days) and **DO NOT give ABX**
38
**_Salmonella typhimurium_** ## Footnote Risk factors Complications
* Risk factors: * Immunocompromised patients (**SICKLE CELL** and HIV) * Complications * **Septic arthritis, osteomyelitis,** and **abcesses**
39
**_Salmonella typhi_** * Micro * Clinical case * Treatment
* **Gram (-) rod; aerobic** that penetrate the mucosa travese intestinal epithelium through M cells over **Peyers patches** * 7-14 days eating ingestion, patients will get **Typhoid fever** (2 sympomtic phase seperated by asymptomatic phase) after international travel or poor sanitation * **Sustained fever (103-4)** + * **Rose colored maculopapular rash** + * **[Pea-soup foul diarrhea]** =\> **bloody diarrhea** and if lumen is too inflamed, constipation *
40
**_Salmonella_** **_typhi_** * Othher associated symptoms * Death most commonly dt:
* Encephalopthy, splenomegaly, bradycardia and dicrotic pulse * Intestinal hemorrhage
41
**_Salmonella typhi_** * Dx
1. **Stool culture** to test for salmonella typi 2. **Blood culture** (90% + when febrile) 3. Fecal leukocytes (+)
42
**_Campylobacter jejuni_** * **Micro** * **Clinical case** * **Treatment**
* **Gram (-) spiral rod;** oxidase (+) with flagella that lives in **wild birds** * Watery =\> blood diarrhea + fever + erythema nodusum that occurs after eating undercooked poultry or dairy * Self limited; no ABX
43
**_Camplylobacter jejuni_** * Dx * Complications
* Dx: * **Stool culture** (bc hard to culture, need **campy blood agar)** * **(+) fecal leukocytes** * Complications * ​Guillian Barre syndrome * Reactive arthritis
44
**_Vibrio_** **_cholerae_** * Micro * Clinical * Treatment
* Gram (-) baccili (comma) that produces toxin; anaerobic + flagells * Profuse watery diarrhea and vomitting =\> dehdration (electrolyte imbalance) that can lead to hypotension =\> renal failure and death and lasts 1 week * Saltwater illness when eating raw seatfood and MC in underdeveloped nations * Rehdration/electrolyte replacement + vaccination
45
**Vibrio cholera** Diagnosis
1. Stool microscopy for curved gram (-) rods 2. Gram stain of stool
46
**_Vibrio Parahemolyticus_** 1. ​Micro 2. Clinical 3. Tx
* **Gram (-) baccili** that produces toxins * Watery =\> bloody diarrhea in colon + N/V/cramps after eating **seafood (shellfish)**
47
**_Vibrio Vulnificus_** ## Footnote ​\_\_\_\_\_\_\_\_\_\_\_ bacteria that causes **D/V** + **pain 16 hours** after ingestion in patients with \_\_\_\_\_\_\_\_\_, causing:
* Gram (-) bacillus * Open wounds in costal salt water or eating oysters * Bullous skin lesions
48
Vibrio Vulnificus is **lifethreating** in ________ patients
**Immunocompromised patients** (esp those with cirrhosis)
49
**Saltwater** illnesses
1. Vibrio cholerae 2. Vibro vulnificus
50
**Freshwater** illnesses
**1. Aeromonas Hydrophila**
51
\_\_\_\_\_\_\_\_\_\_\_ **flesh-eating** bacteria that produces cholera-like diarrhea or bloody stool in patients with **open ankle/foot wounds** in **freshwater** or **eat fish/shellfish**
* **Aeromonas Hydrophila:** Gram (-) non-spore forming rod that is mobile *
52
Wounded patients in freshwater with **flesh eating Aeromonas Hydrophil** can get what complications?
1. **Necrotizing fascitis (flesh eating bacteria)** 2. Can cause **gastroenteritis** in scuba divers who drink a lil
53
**Travelers diarrhea** causes **watery diarrhea** in travelors to ______ countries. Symptoms begin ______ after travel and last \_\_\_\_\_\_\_. Risk factors include:
* Developing countries * 3-5 days * 1-5 days * H2/PPI use =\> lowers pH
54
\_\_\_\_\_\_\_ is the **most common pathogen for travelers diarrhea (TD),** affecting the _______ after ingestion of contaminated \_\_\_\_\_\_\_.
* ETEC: enterotoxogenic E.coli * SI * Water, salads, meats and cheeses
55
Other bacterial causes of TD
1. C. jejuni (asia 2. Salmonella 3. Shigells 4. Aeormonas 5. EAEX 6. Norovirus and coronavirus
56
\_\_\_\_\_\_ is a cause of travelors diarrhea that occurs in vistors to **Russia** or **campers, backpackers in wildness.**
**Giardia-assocaited diarrhea**
57
\_\_\_\_\_\_\_ is a type of TD often occuring on **cruise ships.**
**Norovirus**
58
**Enterotoxigenic: ETEC (E.coli)** is a ___________ bacteria that causes _____ diarrhea and what is unique about diagnosing?
* **Gram (-) rod = SINGLE MOST IMPORTANT AGENT FOR TD** * Watery diarrhea (& occasional fever) * Must be diagnosed clinically: stool cultures **do not differentiate** beteen ETEC and other E.coli in normal colon. * (-) fecal leukocytes
59
* What is the **gram (-) rod** that produces **Shiga-like toxin**?
* E. Coli O157:H7 (Enterohemorrhagic: EHEC) * AKA: STEC (Shiga-toxin producing E.Coli)
60
\_\_\_\_\_\_\_\_\_\_\_\_ is the most common cause of **acute hemorrhagic colitis.**
**E. Coli O157:H7 (Enterohemorrhagic: EHEC)**
61
**E. Coli O157:H7 (Enterohemorrhagic: EHEC)** causes ___________ after ingestion of \_\_\_\_\_\_\_\_.
1. **Watery** =\> **bloody** diarrhea that can cause ischemic colitis 2. **No fever** * Under-cooked hamburger
62
Diagnosis of **E. Coli O157:H7 (Enterohemorrhagic: EHEC)**
1. CBC: peripheral leukocytes, aneumia and thrombocytpenia 2. + fecal leukocytes 3. + fecal lactoferrin 4. Stool culture: Shiga-like toxin
63
**Complications** E. Coli O157:H7 (Enterohemorrhagic: EHEC) **Treatment** of E. Coli O157:H7 (Enterohemorrhagic: EHEC)
1. Complications: 1. Hemolytic uremic syndrome (**HUS**): which is more common in kids and if treated with ABX 2. **Thrombocytopenia** 3. **Renal insufficiency** 2. **Tx:** supportive, rehydration ABX only in severe cases bc can increase risk of HUS
64
What type of e.coli causes **fever**, **abdmoinal pain** and **water=\> dysentary** (bloody diarhea with leukocytes)
**EIEC (Enteroinvasive E.coli)**
65
Name the bacteria **Gram (-) coccobaccili** that causes **bloody diarrhea** + **pharyngitis** + **right sided abdominal pain** that mimic appendicitis/ Crohns because infects **terminal ileum.**
**Yersinia enterocolitica**
66
**Diagnosis** of Yersinia enterocolitica What increases risk of contraction?
1. Stool/blood cultures with + fecal leukocytes 2. Problems with iron metabolism 1. Hemochromatosis 2. Cirrhosis 3. Iron-overload syndromes 4. Aplastic anemia 5. Thalassemia
67
**Yersenia entercolitica** is clinically indistinguishable from \_\_\_\_\_\_\_\_\_\_\_\_. Complications inclue \_\_\_\_\_\_\_\_\_\_\_\_.
* Salmonella or shigella * Reactive arthritis and erythema nodosum
68
**_Name that bacteria_** * Causes **non-bloody diarrhea** + **fever**, most often **pregnant patients** after eating **unpasterized dairy** or **deli meats.** * How it is Dx?
* **Listeria monocytogenes (Gram + rod)** * **Blood culture** or **CSF** bc does not grow on routine stool culture.
69
**_Name that bacteria:_** **Rare multi-system disease** that affects **white men in 40-60s.** Diagnosed with **endoscopy with duodenal biopsy**, we see **PAS (+ MO with bacillus)**.
* **Tropheryma Whipplei (Gram + baccilus, NOT acid fast)**
70
**_Tropheryma Whipplei_** How do we **diagnose**? If untreated?
* ABX that **do not cross BBB** because it affects many systems, including CNS. * Fatal
71
**_Name that bacteria_** Produces **cytotoxins** that cause **_watery_ diarrhea** + **fever** + **pseudomembranes** on colonic mucosa. Diagnosis?
**C. Diff (Gram + baccilis;** anaerobic spore-forming) Dx: * **Stool assay- PCR:** toxin A and B * **+ peripheral leukocytes**
72
Risk factors and Treatment/Prevention and complication for **C.Diff**
* RF: * ABX (clindamyocin, cephalosporin, fluoroquinolones) * Treatment and prevention * Wash hands with soap and water bc germ-ex does not kill * PO/IV metronidazole * PO vanocymocin * Complication * Toxic megacolon
73
When diagnosing **nosocomial infections,** infections most commonly received in hospital or longerterm care facilities, what test is NOT helpful?
**Stool cultures,** except for C.Diff
74
2 most common nosocomial infections
1. C. Diff 2. Norovirus - nursing homes
75
**_Name that virus_** * Virus that is the **most common cause of acute diarrhea** **infants (\< 2 YO)**, especially in the **WINTER**; causing **vomitting** and **watery** **diarrhea** (-\> severe dehydration). * How is it diagnosed?
* **Rotavirus (dsRNA virus)** * **Viral culture or PCR** * **On EM: Wagon wheel appearance**
76
**2nd most common** cause of **GE** in children Sx:
* **Adenovirus** (40 & 41); **dsDNA virus** * **Watery** diarrhea + **fever** (103, 104) + **conjunctivitis** + **pharyngitis**
77
**_Virus_** Virus transmitted fecal-orally when there is an **outbreak** in nursing homes, daycares, schools or cruise ships that causes **vomitting** and **watery diarrhea**. Dx?
* Norwalk virus (norovirus) : small non-enveloped RNA virus * Dx * Routine viral cultures are unrevealing and sxs only last 24-48 hours so **workup is NECESSARY.**
78
Which virus that causes **bloody diarrhea** occurs primarily in **immuncompromised patients** (AIDS and organ transplant with a CD4 count \<200)? Diagnose?
* **CMV (herepesvirus; dsDNA linear)** * **Endoscopy with biopsy** of ulcerated lesions **using CMV specific stains.**
79
What is the most common cause of **dysentary** in the WORLD?
**Entamoeba histolytica**
80
**Entamoeba histolytica** is the most common cause of dystentary in the world. * Complications * Dx?
* Complications 1. Can penetrate bowel =\> portal ciruclation and cause **liver abcesses** (brain and lung) 2. **Toxic megacolon** 3. **Pneumatosis coli** * **Dx** * ​Histology: flask shaped * Stool for ova & parasite * Stool antigen (PCR for DNA)
81
**Entamoeba** occurs most often where?
**Endemic areas:** Asia, Africa, Central/South America
82
Protozoa contracted from **lakes or streams** when **hiking/camping/Russia** causes _persistant_ **watery diarrhea/steatorhea** that is maladorous * Who is more susceptible? * Dx?
1. **Giardia lamblia:** pear-shaped, 4 flagella and 2 nuclei protozoan (trophozoites) 2. **IgA deficiency** 3. Dx: 1. **(-) fecal leukocytes** 2. Check stool for: **ova parasites** and **antigens detection**
83
Protozoa contracted from **swimming pools (resistant to chlorine)** that causes **large volumes of watery diarrhea (\>20 L/day**) that is **self-limited** in **immunocompetant** patients, but l**ife threatning** in **immunosupressed**. * Diagnosis? * Treatment in immunocompetant?
* **Cryptosporidium parvum** * Dx 1. Stool antigen detection or direct microscopy 2. DFA (direct fluorecent antibody), which is modified fast staining * Tx: * Supportive care (hydration), loperamide, nitrazoxanide
84
Parasite that enters through **exposed skin (bare feet on contaminated soil)** and often **asymptomatic**. * Who is more likely to get? * Diagnosis
* **Strongyloides stercoralis (nematode: roundworm)** * **HTLV-1** (Human T-cell Lymphotropic Virus- 1) * Dx * **Rhabditiform larva** and **eosinophils** in stool
85
Parasite found in **produce (lettuce, basil, raspberries)** from endemic areasd that causes **watery diarrhea,** lasting up to 21 days in immunocompetant but **FOREVER** in **immunosupressed**. * What is unlikely to kill this? * Dx?
* **Cyclospora cayetanensis** * **Chlorine** or **iodine** does not kill it * Dx * **Oocysts in stool**
86
Parasite that caues **non-bloody diarrhea,** lasting up for **weeks** and causing m**alabsorption and WL.** In **immunosupressed**/infants/children =\> diarrhea can be **severe**. Upon diagnosis, we see **eosinophilia** and we need to **repeat stool exams and concentration procedures.** **What is this?** **What happens if stool exam is (-)**
* **Cystoisospora belli** * If (-), **biopsy duodenal specimen**s * **Oocysts** can be seen on **modified acid fast stain.**
87
**Hookworm/whipworm** transmited **fecal-orally** **(ingesting eggs in soil).** They can get REAL long and cause **bowel obstruction.**
**Ascaris lumbricoides**
88
**Fish tapeworm** in **raw/undercooked fish** that can cause **vit B12 defieincy=\> p**ernicous anemia and neuro symptoms.
**Diphyllobothrium latum**
89
2nd most common cause of **esophageal varices**, behind alcohol in Africa that we get from containated **freshwater snails.** Leads to and treatment?
* **Schistosoma mansoni** * Bloody stool, bladder cancer and liver cysts * Tx: praziquentel
90
\_\_\_\_\_\_\_ pork tape worm. \_\_\_\_\_\_\_\_ beef tape worm. Sxs
* **Taenia solium** =\> pork * Mostly asymptomatic; rare cases get **seizures (cysticercosis)** * **Taenia saginat**a =\> beef * Mostly asympomatic
91
**Tapworm** contracted when **sheep** are **slaughtered** unsatirily. How do we get? Leads to? CT?
* **Echinococcus granulosus** * Fecal oraly: **Dogs** are carriers =\> pet dogs * Cysts in lungs/liver * CT: * Free-flowing hyatid sand
92
**Pinworm** that we contract **fecal-orally**, leading to **peri-anal itching** that can be diagnosed by **scotch tape.** Treated with\_\_\_\_\_\_.
**Enterobius vermicularis (pinworm)**
93
How can we prevent pinworm infection?
1. Wash hands 2. Cut nails 3. Tell kids dont scratch ass 4. Change and wash 5. Do not shake towels or sheeds 6. Vaccum/mop floor 7. Disinfect bc can survive 3 weeks
94
Main forms of treatment for Acute infections Diarrhea
1. Hydration (PO/IV) 2. Maintain electrolytes 3. ABX not required unless stated 4. Anti-motility agents in patients with NO fever and NON-bloody stools
95
**Anti-motility agents** should NOT be used in what 2 pathogens?
1. **C. diff** 2. **EHEC**
96
\_\_\_\_\_\_\_\_\_\_ is used to **prophylax** and **prevent** acute infectious diarrhea.
Wash hands with **soap**
97
**Alcohol gels** are INEFFECTIVE against (2)
1. C. Diff 2. Norovirus
98
\_\_\_\_\_\_\_\_\_\_ is used to prophylax and prevent acute infectious diarrhea in *travelors*.
1. **Bismuth subsalicylate** can reduce frequency, but can cause poops/tongue to be dark 2. **Antibiotic prophlaxis (PPX)** in indicated patients
99
Taking PPX with _______ is NOT recommended.
**ABX**
100
Patient has **reactive arthritis (artheritis, uretheritis and conjunctivitis)**. What is your DDX?
1. **Salmonella** 2. **Campylobacter** 3. **Shigella** 4. **Yersenia**
101
Patient has **Guillian-Barre Syndrome.** What is your DDX?
**Campylobacter jejuni**
102
**Yersinosis** can lead to what?
1. AI type thyroiditis 2. Pericarditis 3. Glomerulonephritis
103
Patient has **HUS**. What is your DDX?
1. **Enterohemorrahge E. coli (O157:H7)** 2. **Shigella**
104
What pathogens typically affect Large Bowel?
1. Campylobacter 2. Salmonella 3. Shigella 4. Yersinia 5. EIEC, EHEC 6. C.Diff 7. Vibrio parahaemo 8. E. Histolytica 9. CMV 10. Adenovirus 11. HSV
105
What pathogens affect small bowel?
1. Salmonella, 2. Vibrio cholerae, 3. ETEC, EPEC, 4. Yersinia, 5. Rotavirus, Norovirus, CMV, Adenovirus, 6. Giardia, 7. Cryptosporidium, 8. Cyclospora, 9. Clostridium perfringens, 10. Staph aureus, 11. Bacilliscereus
106
Ppl wih **hemochromatosis** are prone to invasive, fatal, enteric infections, such as
* 1. Vibrio species * 2. Listeria * 3. Yersinia
107
Patients with AIDS are prone to enteric pathogens that causes more severe and protracted diarrhea. What opportunitistic infecitons, viruses and protozoa are they?
* Opportunistis infections (Mycobacterium) * Viruses * CMV, Adenovirus, HSV * Protozoa * Cryptosporidium, Cystoisosporabelli, Microsporida, and Blastocystishominis
108

GI II Exam 1 (19 decks)

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