Gastritis/Duodenitis Flashcards
Define gastroenteritis
Acute gastritis is inflammation of the stomach and presents with nausea and vomiting. Enteritis is inflammation of the intestines and presents with diarrhoea. Gastroenteritis is inflammation all the way from the stomach to the intestines and presents with nausea, vomiting and diarrhoea.
Most common cause of gastritis
viral
What is essential in gastritis in healthcare
isolation
Viral gastritis causes
Rotavirus
Norovirus
Adenovirus is a less common cause and presents with a more subacute diarrhoea
What is E.coli
Escherichia coli (E. coli) is a normal intestinal bacteria. Only certain strains cause gastroenteritis. It is spread through contact with infected faeces, unwashed salads or water.
What causes haemolytic uraemic syndrome?
E. coli 0157 produces the Shiga toxin. This causes abdominal cramps, bloody diarrhoea and vomiting. The Shiga toxin destroys blood cells and leads to haemolytic uraemic syndrome (HUS).
The use of antibiotics increases the risk of haemolytic uraemic syndrome therefore antibiotics should be avoided if E. coli gastroenteritis is considered.
What is a common cause of traveller’s diarrhoea?
Campylobacter jejuni
What is campylobacter spread by?
Raw or improperly cooked poultry
Untreated water
Unpasteurised milk
How does campylobacter infection present?
ncubation is usually 2-5 days. Symptoms resolve after 3-6 days. Symptoms are:
Abdominal cramps
Diarrhoea often with blood
Vomiting
Fever
When are antibiotics used in campylonacter?
Antibiotics can be considered after isolating the organism where patients have severe symptoms or other risk factors such as HIV or heart failure. Popular antibiotic choices are azithromycin or ciprofloxacin.
Outline shigella infection
Shigella is spread by faeces contaminating drinking water, swimming pools and food. The incubation period is 1-2 days and symptoms usually resolve within 1 week without treatment. It causes bloody diarrhoea, abdominal cramps and fever. Shigella can produce the Shiga toxin and cause haemolytic uraemic syndrome. Treatment of severe cases is with azithromycin or ciprofloxacin.
Outline salmonella
Salmonella is spread by eating raw eggs or poultry and food contaminated with infected faeces of small animals. Incubation is 12 hours to 3 days and symptoms usually resolve within 1 week. Symptoms are watery diarrhoea that can be associated with mucus or blood, abdominal pain and vomiting. Antibiotics are only necessary in severe cases and guided by stool culture and sensitivities.
What is bacillus cereus and how is it easy to distinguish?
gram positie rod
patient develops symptoms soon after eating leftover fried rice that has been left at room temperature. It has a short incubation period after eating the rice and they then recover within 24 hours.
Whilst growing on the food it produces a toxin called cereulide that causes abdominal cramping and vomiting within 5 hours of ingestion. When it arrives in the intestines it produces different toxins that cause a watery diarrhoea. This occurs more than 8 hours after ingestion.
Where else can you encounter bacillus cereus?
The other place you may come across bacillus cereus is in intravenous drug users (IVDU) that develop infective endocarditis. Staphylococcus is the most common cause of IE in IVDUs but bacillus cereus is one to keep in mind.
Outline yersinia enterocolitica
Yersinia is a gram negative bacillus. Pigs are key carriers of Yersinia and eating raw or undercooked pork can cause infection. It is also spread through contamination with the urine or faeces of other mammal such as rat and rabbits.
Yersinia most frequently affects children causing watery or bloody diarrhoea, abdominal pain, fever and lymphadenopathy. Incubation is 4-7 days and the illness can last longer than other causes of enteritis with symptoms lasting 3 weeks or more. Older children or adults can present with right sided abdominal pain due mesenteric lymphadenitis (inflammation in the intestinal lymph nodes) and fever which can give the impression of appendicitis.
