Enteric pathogens Flashcards
Gastroenteritis
Syndrome of N+V, diarrhoea, and abdom pain
What is diarrhoea
- Abnormal loose stool with high levels of water and electrolyte loss
- Bristol stool chart to measure consistency of stool - 5-7 is indicative
Dysentery is what
Inflammatory bloody diarrhoea
Infection is caused by what?
Bacteria
Virus
Protozoa
Helminth worm infections
Detection/ Investigations
Microscopy
Antigens
PCR
Stool culture
What culture do we use for lactose fermenting?
Macconkey
Before use: Pink
LF: Darker pink/ red
Non LF: Yellow colourless
XLD to differentiate salmonella and shigella
Salmonella - Red with black colorless
Shigella - red colourless only
Different serotypes of salmonella
- Diarrhoea - S. enteridis - Poultry and raw eggs - 36 hours for symptoms - self limiting
- Typhoid fever - salmonella typhi - symptoms after 20 - 21 days - need fluroquinolones - SE Asia and Tropical
Shigella
- Causes shigellosis and dysentery
- Produces shiga toxin
- Also shiga like toxin which is released by strands of E coli
Shigella cause haemolytic syndrome
Caused by E. choli which is produced by Shiga like toxin
Shellfish and Chicken at restaurant day before and presents acutely unewell with diarrhoea what will u suspect?
- Campylobacteria gastritis
- Gram-negative curved rods
- Campylobacter - most common type in UK - causes GBS
- GBS ascending polyneuropathy - starts at feet to leg to hands to arm then rest of body
- Clarithromycin
Viral causes of diarrhoea
Adults - Norovirus
Children - Rotavirus
Tell Public Health England
Supportive treatment
Anyone with diarrhoea on antibiotics that start with Cs cause what type of bacterial diarrhoea?
C difficile
Tx - stop c antibiotics and start vancomyocin 125mg 4X daily for 10 days
Patients isolated for 48 hours
Appendix
Suspect intrabdominal infections or SBP
Pathogens that cause appenicitis
Gram - E. coli Klebsiella and enterobacteria
Gram positive - enterococci
