Gastroenteritis Flashcards
What is acute gastritis
inflammation of the stomach and presents with nausea and vomiting
What is gastroenteritis
inflammation all the way from the stomach to the intestines and presents with nausea, vomiting and diarrhoea.
What is the most common cause of gastroenteritis
viral:
- Rotavirus
- Norovirus
- Adenovirus is a less common cause and presents with a more subacute diarrhoea
What is E. Coli
- Not all strains cause gastroenteritis (some normal gut)
- spread through contact with infected faeces, unwashed salads or water
Which strain of E.coli is dangerous
- E. coli 0157 produces the Shiga toxin
- abdominal cramps, bloody diarrhoea and vomiting
- Shiga toxin destroys blood cells and leads to haemolytic uraemic syndrome (HUS).
Why do we avoid antibiotics in gastroenteritis, especially when e.coli suspected
antibiotics increases the risk of haemolytic uraemic syndrome
What is Campylobacter Jejuni
- common cause of travellers diarrhoea
- most common bacterial cause of gastroenteritis worldwide
- a gram negative bacteria that is curved or spiral shaped.
- Incubation 2-5 days
How is Campylobacter Jejuni spread
Raw or improperly cooked poultry
Untreated water
Unpasteurised milk
What are the symptoms of Campylobacter Jejuni
Abdominal cramps
Diarrhoea often with blood
Vomiting
Fever
When should you considered antibiotics in patients with campylobacter
- 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.
What is Shigella
- spread by faeces contaminating drinking water, swimming pools and food.
- incubation period is 1-2 days
- symptoms usually resolve within 1 week without treatment.
Symptoms of Shigella
- bloody diarrhoea
- abdominal cramps
- fever
- can produce the Shiga toxin and cause haemolytic uraemic syndrome
What is the treatment of Shigella
- Nil if not severe
- If severe, azithromycin or ciprofloxacin.
What is Salmonella
- spread by eating raw eggs or poultry and food contaminated with infected faeces of small animals
- Incubation 12 hours - 3 days
- symptoms usually resolve within 1 week
What are the symptoms of salmonella
- watery diarrhoea
- can be associated with mucus or blood, abdominal pain and vomiting.
What is the management of salmonella
- Antibiotics are only necessary in severe cases and guided by stool culture and sensitivities.
possible post-gastroenteritis complications
Lactose intolerance
Irritable bowel syndrome
Reactive arthritis
Guillain–Barré syndrome
What is Bacillus Cereus
- gram positive rod that is spread through inadequately cooked food (fried rice) (occasionally IVDU)
- Whilst growing on the food it produces a toxin called cereulide
Symptoms of Bacillis Cereus
- abdominal cramping and vomiting (5 hours)
- watery diarrhoea (>8 hours after ingestion.)
- All of the symptoms usually resolves within 24 hours.
What is Yersinia Enterocolitica
- gram negative bacillus
- Incubation is 4-7 days
- symptoms lasting 3 weeks or more
Causes of Yersinia Enterocolitica
- Pigs are key carriers of Yersinia (raw or undercooked pork)
- also spread through contamination with the urine or faeces of other mammal such as rat and rabbits.
Symptoms of Yersinia Enterocolitica
- Children: watery or bloody diarrhoea, abdominal pain, fever and lymphadenopathy
- Adults: right sided abdominal pain due mesenteric lymphadenitis (inflammation in the intestinal lymph nodes) and fever which can give the impression of appendicitis.
What is Staphylococcus Aureus Toxin
- The bacteria doesn’t cause the enteritis but the staphylococcus enterotoxin which causes the symptoms
- symptoms start within hours of ingestion and settle within 12-24 hours
What are the symptoms of Staphylococcus Aureus Toxin
- diarrhoea
- perfuse vomiting
- abdominal cramps
- fever
What is Giardiasis
- microscopic parasite: lives in the small intestines of mammals.
- may be pets, farmyard animals or humans
- releases cysts in the stools of infected mammals
- cysts then contaminate food or water and are eaten to infect a new host
What is the presentation and management of giardiasus
- may not cause any symptoms or it may cause chronic diarrhoea.
- Diagnosis is made by stool microscopy
- Treatment is with metronidazole.
Mangement of gastroenteritis
- Fluid challenge, if tolerate, consider outpatient mangement: Diarolylite vs iv fluids
- microscopy, culture and sensitivities
- Off school and work until symptoms resolved for 48 hrs
- Anti-diarrhoeal medications
- Anti-emetics
When should you avoid anti-diarrhoeal medications
- e. coli 0157
- shigella infections
- bloody diarrhoea
- high fever.
