Gastroenteritis Flashcards
differentiate enteritis and gastroenteritis
enteritis - inflammationm of intestines-> presents with diarrhoea
gastroenteritis - inflam from stomach to intestines
-presents with nausea vomitting and diarrhoea
main concern with gastroenteritis in children 1
dehydration
-establish whether they need IV fluids and admission Or can hydrate themselves
differential diagnosis for loose stools children 8
Infection gastroenteritis
IBD
Lactose intolerance
coeliac disease
Cystic fibrosis
Diarrhoea toddlers
Irritable bowel syndrome
Medications- ABX
most common type of gastroenteritis -1
-causes -2
viral
rotavirus
norovirus
Presentation of viral gastroenteritis caused by adenovirus 1
less common
more subacute diarrhoea
bacterial causes of gastroenteritis 6
E. coli
campylobacter jejuni
shigella
bacillus cereus
Yersinia enterocolitica
staph aurea toxin
parasitic cause of gastroenteritis 1
Giardiasis
How is E. coli spread 3
Infected faeces
unWashed salads
Contaminated water
what type of E. coli is a particular concern what does it produce and what is its affect
E Coli 0157
-produces Shiga toxin
-shiga toxin destroys blood cells and can lead to haemolytic uraemic syndrome
Important factor when treating E. coli 0157
using ABx Increases the risk of HUS and should be avoided
what is a common cause of travellers diarrhoea
Campylobacter jejuni
-most common cause of bacterial gastroenteritis worldwide
how is campylobacter spread
Raw are improperly cooked poultry
Untreated water
Unpasteurised milk
incubation of campylobacter jujuni and length of syx
incubation 2-5 days
syx resolve after 3-6 days
symptoms of campylobacter Jejuni 4
abdo cramps
diarrhoea -often w blood
vomiting
fever
when would antibiotics be considered for a campylobacter infection
once bacteria isolated adn if:
-patient has severe syx
-or underlying health conditions ie HIV or heart failure
antibiotics for campylobacter Jejuni infection 2
azitrhomycin or ciprofloxacin
How is shigella spread 3
spread by faeces in
- contaminated drinking water
-contaminated swimming pools
-contaminated food
incubation period and length of symptom symptoms in shigella infection
incubation period one to 2 days
Symptoms resolve within a week without treatment
symptoms of shigella infection 3
Bloody diarrhoea
Abdo cramps
Fever
treatment of severe shigella infection 2
ABX
-azitrhomycin
-ciprofloxacin
what can shigella produce and what can this lead to
Shiga toxin
this can cause haemolytic uraemic syndrome
how is salmonella spread 2
Eating raw eggs or poultry
Food contaminated with infected faeces of small animals
incubation period and length of symptoms and salmonella infection
incubatino period is 12 hours to 3
Symptoms resolve within one week
symptoms of salmonella infection 3
Watery diarrhoea- a associated with mucus or blood
abdo pain
vomitting
when can antibiotics be used and salmonella infection
Only in severe cases
-guided by stool cultures and sensitivites
how is bacillus cereus spread
through inadequatley cooked foods
or
grows well on food not immediately refrigerated after cooking
-typical food is fried rice left at room temp
what toxin does bacillus cereus produce
cereulide
whaat symptoms do the toxin of bacillus cereus cause (2) and after what length of time
*when bacillus cereus arrives in the intestines, what symptoms can occur
abdo cramps
vomiting
-within 5 hours of ingestion
*produces different toxins-> caues watery diarrhoea
-occur around 8 hours after digestion
typical course of bacillus cereus infection
vommintng after 5 hours
diarrhoea after 8 hours
resolution after 24hours
how does yersinia enterocolitica spread 1
pigs key carriers
-earting raw or undercooked pork
spread trhough contaminaitno with the urine or faeces of other mamals like rats and rabbits
presenation of yersinia enterocolitica in a child 4
watery or bloody diarrhoea
fever
abdo pain
LYMPHADENOPATHY
presenation of yersinia enterocolitica in older children and adults
right sided abdo pain
-due to MESENTERIC LYMPHADENITIS
-gives impression of appendicitis
course of yersinia enterocolitica infection
incubation 4-7days
-can last longer than other gastroenteirits
-3 weeks or more
when are abx used for yersinia enterocolitica
only in severe cases
-guided by stool cultures and sensitivities
what can staph aureus produce with regards to gastroenteritis
-what can be contaminated
prodcues enterotoxins
-grows on foods luke eggs diary and meat
what happens when staph aures toxins (enterotoxins) are ingested
-whats the syxx 5
causes small intestine inflam
-diarrhoea
-perfuse vomitting
-abdo pain
-fever
-abdo cramps
course of staph aures toxins (enterotoxins) infection
syx within hours of ingestion
-settle within 12-24 hours
important point to note regarding staph arues related gastroenteritis
not the bacteria causing the enteritis but hte staphylococcus enterotoxin
overview of giardisis contamination route
lives in the small intestines of mammals. These mammals may be pets, farmyard animals or humans. It releases cysts in the stools of infected mammals. The cysts contaminate food or water and are eaten, infecting a new host. This is called faecal-oral transmission.
presenatino of giardisis
may be asymptomatic or cause chronic diarrhoea
diagnosis of giardis and treatment
made by stool microscopy
-treatment with metrodiazole
prinicples of gastroenteritis managemnt 3
when patient develops syx- isolated
-barrier nursing
-infection control
stay of school until 48hours AFTER syx fully resolve
faecal microscopy, culture and senstivities to establish causative organism and ABx senstivities\
-once oral intake tolerated-> light diet slowly reintroducted
fluid management in gastroenteritis 3
ensure they remain hydraged whilst waiting for diarrhoea and comiting to settle
-attempt fluid challege
-give small amoount of fluid ervery 5-10 minutes
-ensure they can tolerate
-use diaorlayte if tolerated
-if child fails fluid challenge may require IV fluids
when shoudl antidiarrheal medication and metoclopramide be particulary avoid in gastroenteritis 3
e coli 0157
shigella
bloody diarrhoea
high fever
*ANTIDIARRHEAL AND ANTIEMETICS ARE GENERALLY NOT RECOMMENED FOR GASTROENTERITIS MANAGEMENT
post gastroenteritis complications 4
lactose intolerance
irritable bowel syndrome
reactive arthitis
guillain-barre syndrome
clinical signs of dehydration in a child 8
dry mucous membranes
suken fontanelle
depressed level of consciousness
sunken eyes
tachypneao,tachycaridc, prolonged CRT
decreased skin turgor
wight loss
oliguria
how to assess for decreased skin turgor
(pinch some skin over chest/ abdo, if it does not return
almost immediately then skin turgor abnormal)
