Gastroenteritis Flashcards
What is acute gastritis?
Inflammation of the stomach & presents with N&V
What is enteritis?
Inflammation of the intestines & presents with diarrhoea
What is gastroenteritis?
Inflammation from the stomach to the intestines & presents with nausea, vomiting & diarrhoea
What’s the most common cause of gastroenteritis?
Viral (x3)
- Rotavirus (infantile)
- Norovirus (all ages)
- Adenovirus (resp)
In which patients is gastroenteritis potentially fatal?
very young & old patients or those with other health conditions
Which virus is less common and how does it present differently?
Adenovirus - more subacute diarrhoea
Which strain of E.Coli causes gastroenteritis and can lead to haemolytic uraemic syndrome?
E. Coli 0157 –> produces Shiga toxin –> destroys blood cells causing HUS
Why should you avoid antibiotic treatment if E. Coli gastroenteritis is considered?
Increases the risk of haemolytic uraemic syndrome (HUS)
Which organism commonly causes travellers diarrhoea
Campylobacter Jejuni
Which organism is the most common bacterial cause of gastroenteritis (most common food poisoning in UK)
Campylobacter Jejuni
Micro of campylobacter?
Means ‘curved’ bacteria = spiral shaped
Gram negative
How is campylobacter spread?
(1) Raw/improperly cooked poultry - “summer BBQ”
(2) Untreated water
(3) Unpasteurised milk
What are the symptoms of Campylobacter gastroenteritis?
Incubation 2-5d, symptoms resolve after 3-6d:
- Abdo cramps
- Diarrhoea - often w/ blood
- Vomiting (rare)
- Fever
Which abx would you use if patient had Campylobacter w/ severe sx or risk factors (HIV or heart failure)?
Azithromycin OR ciprofloxacin
Presentation of Shigella?
Incubation 1-2d, symptoms resolve after 1wk:
- Bloody diarrhoea
- Abdo cramps
- Fever
Treatment of shigella (if severe case)?
Azithromycin or ciprofloxacin
How is shigella spread?
Spread by faeces contaminating water, swimming pools and food
How is salmonella spread?
Eating raw eggs or poultry
Eating food contaminated w/ infected faeces of small animals
Symptoms of salmonella?
Incubation 12hr to 3d, symptoms resolve after 1wk.
- watery diarrhoea - possible blood/mucus
- abdo pain
- vomiting
Micro of Bacillus Cereus?
Gram-positive
Rod shape
Symptoms of Bacillus Cereus?
Vomiting within 5hrs (30mins)
Diarrhoea after 8hrs
Resolution within 24hrs
How is Bacillus Cereus spread?
- Inadequately cooked food
- Food not immediately refrigerated
- Classic = symptoms soon after left out leftover rice + recover within 24hrs
What other infection does Bacillus Cereus cause in IVDU?
Infective endocarditis
Micro of Yersinia Enterocolitica?
Gram negative bacillus
Key carrier of Yersinia Entercolitica?
Pigs (raw or undercooked)
Symptoms of Yersinia Enterocolitica?
Incubation 4-7d, symptoms last up to 3wks!!
- children
- watery + bloody diarrhoea
- abdo pain
- fever
- LYMPHADENOPATHY
- MESENTERIC LYMPHADENITIS –> (older children/adults) presents as R-abdo pain + fever (commonly mistaken for appendicitis)
symptoms of Staph. Aureus (enterotoxin)?
Incubation 1-6hrs. Settle <24hrs.
- PROFUSE vomiting
- mild diarrhoea
- abdo pain
High-risk food of Staph. Aureus spread?
Those made by hand and requires no cooking (pastries, sandwiches, slices meat)
How does norovirus present?
Incubation 12-24hrs.
- PROJECTILE vomiting
- diarrhoea mild, non-bloody
How is norovirus spread?
Seafood e.g. mussles not cooked well
What is giardiasis?
Giardia Lamblia is a microscopic parasite and lives in the small intestines
Spread of giardiasis?
Faecal-oral transmission.
Produce cysts in stools of infected animals which contaminate water/food.
Post-Gastroenteritis Complications? (x4)
(1) lactose intolerance
(2) IBS
(3) Reactive arthritis
(4) Guilain-Barre syndrome
How would you diagnose + treat of Giardiasis
diagnosis - stool microscopy
treatment - metronidazole
Geneeral management of gastroenteritis?
(1) Send stool sample (MC&S)
(2) Assess dehydration - fluid bolus?
(3) When not vomiting - home + dioralyte
(4) advise to stay off work/school for 48hrs after symptoms resolve
(5) Antidiarrhoeals
When would you avoid antidiarrhoeal medication (loperamide / metoclopramide)?
If E. Coli 0157 or Shigella
