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Microbiology and Infectious Disease > Gastrointestinal Infections - Part 1 > Flashcards

Gastrointestinal Infections - Part 1 Flashcards

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1
Q

What is the microbiology and pathogenesis of Campylobacter infection?

A
  • Curved Gran-neg bacilli
  • Inflammation, ulceration and bleeding
  • Bacteraemia can occur
  • Can lead to Guillain-Barre
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2
Q

What are the clinical features and treatments for Campylobacter infection?

A
  • Incubation 2-5 days
  • Bloody diarrhoea, abdominal cramps, fever
  • Duration 2-10 days
  • Treat with fluids, clarithromycin in persistent disease, quinolone or aminoglycoside for invasive disease
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3
Q

What is the microbiology and pathogenesis of Salmonella infection?

A
  • Gram-neg bacilli
  • Diarrhoea due to invasion of epithelial cells in distal small intestine, and subsequent inflammation
  • Bacteraemia can occur
  • Distant organs can be seeded
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4
Q

What are the clinical features and treatments for Salmonella infection?

A
  • Incubation 12-72hrs
  • Watery diarrhoea, vomiting, fever
  • Duration 2-7 days
  • Treat with fluids, beta-lactams, quinolones of aminoglycosides in severe infections
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5
Q

What is the microbiology and pathogenesis of Shigella infection?

A
  • Gram-neg bacilli
  • Organisms attach and colonise mucosal epithelium of terminal ileum and colon
  • S. dysenteriae produces exotoxin (Shiga toxin) which can lead to HUS
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6
Q

What are the clinical features and treatments for Shigella infection?

A
  • Dysentery
  • Incubation 1-3 days
  • Duration 2-7 days
  • Watery followed by bloody diarrhoea, cramping abdominal pain
  • Usually self-limiting, can give fluids
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7
Q

What is the microbiology and pathogenesis of Vibrio cholera infection?

A
  • Comma-shaped Gram-neg bacilli
  • Flagellae and mucinase facilitate penetration of intestinal mucous
  • Attach to mucosa and diarrhoea production due to potent protein exotoxin
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8
Q

What are the clinical features and treatments for Vibrio cholera infection?

A
  • Severe, profuse, non-bloody, watery diarrhoea
  • Fluid loss and dehydration leads to hypokalaemia, metabolic acidosis and hypovolaemic shock
  • Prompt oral or IV antibiotics indicated
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9
Q

What is the microbiology and pathogenesis of E. coli (specifically EHEC) infection?

A
  • Gram-neg bacilli
  • Attaching and effacing lesion
  • Production of Shiga like toxin
  • E. coli O157:H7 best known serotype
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10
Q

What are the clinical features and treatments for E. coli (specifically EHEC) infection?

A
  • Incubation 1-7 days
  • Duration 5-10 days
  • Bloody diarrhoea, can lead to HUS (in case of O157:H7)
  • Rehydration, antibiotics not indicated
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11
Q

What is the microbiology and pathogenesis of Yersinia enterocolica infection?

A
  • Gram-neg bacilli
  • Invades terminal ileum with inflammation of mesenteric lymph nodes
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12
Q

What are the clinical features and treatments for Yersinia enterocolica infection?

A
  • Incubation 4-7 days
  • Duration 1-2 weeks
  • Diarrhoea, may have blood, abdominal cramps, fever and mesenteric adenitis
  • Generally self limiting but may require quinolones or aminoglycosides in severe cases
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13
Q

What is the microbiology and pathogenesis of S. aureus infection?

A
  • Gram-pos cocci
  • 50% produce exotoxins, heat-stable and acid-resistant protein toxins
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14
Q

What are the clinical features and treatments for S. aureus infection?

A
  • Incubation 30mins-6hrs
  • Duration 12-24hrs
  • Vomiting and abdominal cramps
  • Self-limiting
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15
Q

What is the microbiology and pathogenesis of Bacillus cerus infection?

A
  • Aerobic, spore-forming Gram-pos bacilli
  • Two types of disease; emetic (toxin during storage) and diarrhoeal (toxin produced in gut)
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16
Q

What are the clinical features and treatments for Bacillus cerus infection?

A
  • Incubation 30mins-6hrs
  • Duration 12-24hrs
  • Vomiting (not in diarrhoeal), watery diarrhoea and abdominal cramps
  • Self-limiting
17
Q

What is the microbiology and pathogenesis of Clostridium perfringens infection?

A
  • Anaerobic, spore-forming Gram-pos bacilli
  • Spores survive cooking and germinate
  • Organisms ingested and sporulate in large intestine with production of enterotoxin
18
Q

What are the clinical features and treatments for Clostridium perfringens infection?

A
  • Incubation 6-24hrs
  • Duration 12-24hrs
  • Watery diarrhoea and abdominal cramps
  • Self-limiting disease
19
Q

What is the microbiology and pathogenesis of Clostridium botulinum infection?

A
  • Anaerobic, spore-forming Gram-pos bacilli
  • Foodborne, infant and wound botulism
20
Q

What are the clinical features and treatments for Clostridium botulinum infection?

A
  • Neuromuscular blockade results in flaccid paralysis and progressive muscular weakness
  • Can lead to respiratory failure due to muscle weakness in chest/diaphragm
  • Urgent intensive care support
  • Antitoxin
21
Q

What is the microbiology and pathogenesis of Clostridium difficile infection?

A
  • Anaerobic, spore-forming Gram-pos bacilli
  • Infection requires disruption of normal gut flora
  • Often prior to treatement with antibiotics (i.e. clindamycin, fluoroquinolones, ciprofloxacin, penicillins and cephalosporins)
  • Causes elimination of gut commensals and overgrowth of toxin producing C. difficile
  • Diagnosed by finding toxin in the stool
  • Treated with vancomycin
22
Q

What are the clinical features and treatments for Clostridium difficile infection?

A
  • Mild to severe abdominal pain, pseudomembranous colitis and colonic dilatation/perforation
  • Stop precipitating antibiotics, give oral metronidazole in mild and vancomycin in severe cases
23
Q

What is the microbiology and pathogenesis of Listeria monocytogenes infection?

A
  • Gram-positive coccobacilli
  • Invasive infection from GIT results in systemic spread via bloodstream
24
Q

What are the clinical features and treatments for Listeria monocytogenes infection?

A
  • Incubation around 3 weeks
  • Duration 1-2 weeks
  • Flu-like illness, can have diarrhoea, septicaemia and meningitis
  • IV antibiotics (usually ampicillin and gentamicin)
25
Q

What is the microbiology and pathogenesis of Helicobacter pylori infection?

A
  • Gram-neg spiral shaped bacilli
  • Involves cytotoxin production and a range of factors to proote adhesion and colonisation
26
Q

What are the clinical features and treatments for Helicobacter pylori infection?

A
  • Infection is asymptomatic unless peptic ulceration develops
  • Increased risk of gastric cancer
  • PPIs and combinations of oral antibiotics such as clarithromycin and metronidazole
27
Q

What causes Whipple’s disease and how is it diagnosed?

A
  • Infection by Tropheryma
  • Diagnosed on biopsy of duodenum - PAS positive macrophages
28
Q

What are the features of Entamoeba Histolytica Infection?

A
  • Intestinal amebiasis may involve any part of the bowel
  • Small foci of necrosis that progress to ulcers
  • Flask-shaped ulcer with narrow neck and broad base
  • May metastasize to the liver
29
Q

What does M. Tb do to the GIT?

A
  • Granulomatous inflammation with confluent granulomas, usually with caseous necrosis
  • Loss of crypts
  • Fibrin and acute inflammatory cells present
  • Endoscopic findings include strictures, ulcers and mucosal hypertrophy
30
Q

What is tropical sprue a histological mimic of and how is it treated?

A
  • Coeliac disease
  • Treat with tetracycline

Microbiology and Infectious Disease (15 decks)

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