Gastroenteritis Flashcards
Sources of GI infections:
1) Infected food and water
2) Fecal-oral transmission (via contaminated objects)
3) Person-to-person transmission
Most likely illness in recent travelers:
ETEC (enterotoxigenic E. coli)
Most likely illnesses in food-borne infections:
Norovirus Salmonella (NOT typhi) Toxoplasma Listeria Campylobacter
Food-borne infections (1-6 hour incubation):
Staph aureus: mayo, cream pastry, ham, poultry
Bacillus cereus: fried rice
Food-borne infections (8-14 hour incubation):
Clostridium perfringens: beef, poultry, legumes, gravy
Bacillus cereus: meat, vegetables, dried beans, cereals
Food-borne infections (>16 hour incubation):
Vibrio cholera: shellfish
Vibrio parahemolyticus: oysters, shellfish
ETEC: salad, cheese, meat, water
Salmonella: beef, poultry, eggs, dairy
Shigella: potato or egg salad, lettuce, raw vegetables
Most likely illness following antibiotic treatment:
Clostridium difficile
Most likely illness following sexual contact:
Shigella (among MSM). Hepatitis A.
Most likely illness from pets:
Salmonella from reptiles and amphibians. Recent turtle outbreaks of S. enterica.
Most likely in the immunodeficient:
Cryptosporidium, microsporidium, cyclospora, isospora.
Most likely in pregnant women:
Listeria, hepatitis E
Most likely in the young:
Rotavirus, norovirus
Causes of non-inflammatory (enterotoxic) diarrhea:
Vibrio cholerae Clostridium perfringens Bacillus cereus ETEC Rotavirus Giardia Cryptosporidium
Causes of inflammatory (invasion or cytotoxic) diarrhea:
Shigella Salmonella (not Typhi) Campylobacter EHEC EIEC Yersinia enterocolitica Vibrio parahemolyticus Clostridium difficile Entamoeba histolytica
Causes of penetrating diarrhea:
Salmonella typhi
Yersinia enterocolitica
Diarrhea:
Acute (0-14 days)
Persistent (>14 days)
Chronic (>30 days)
Although gastroenteritis is typically self-limited, the following scenarios require further work-up:
Bloody diarrhea
Profuse diarrhea with evidence of hypovolemia
Small volume stools with blood and mucus
Hospitalized, immunocompromised, and pregnant patients
Fever or other evidence of systemic disease
Duration of symptoms >48 hours, or >6 stools in 24 hours
Diarrhea in the setting of recent antibiotic exposure.