GI bugs Flashcards
what are the clinical presentation of Campylobacter?
gastroenteritis - bloody fever abdo pain tenesmus myalgia bacteremia Focal extraintestinal infections - meningitis, pancreatitis, cholecystitis, all over \+++ if animal contact, unpasteurized milk
What are complications of campylobacter
reactive arthritis - especially if have HLA B27, large jt
GBS - 25% of GBS cases
erythema nodosum
IgA nephropathy
how do you treat Campylobacter?
treat ONLY if very sick or immunocompromised or chronic conditions or immunosuppressed.
Azithr or erythromycin
(AAP-erythromycin or azithromycin can eradicate the organism within 2 to 3 days, shorten the duration of illness, and prevent relapse when administered early in the course of infection.)
what are clinical features of Cryptosporidium infection
PROTOZOA non bloody profuse diarrhea crampy abdo pain nausea/vomiting 30-50% fever myalgia
how can campylobacter present in the immunocompromised patient?
Chronic diarrhea can lead to malnutrition, anorexa.. Biliary tract disease - RUQ pain, fever, N/V/D Pancreatitis Resp symptoms
How do you treat Cryptosporidium?
only if really unwell
Niatozoxanide
what can cause an mono-like illness (acute retroviral syndrome)
CMV adenovirus toxoplasma gondii Hep B Hep C HIV
what location of lymphadenopathy is particularly suggestive of EBV?
epitrochlear
what are Ca that have been linked with EBV?
Burkitt lymphoma
nasopharyngeal Ca
Hodgkin
Lymphoproliferative disease
how do you treat protozoan Entamoeba histolytica
- eradicating the active trophozoites (with metronidazole)
2. intraintestinal cysts (with paromomycin or iodoquinol
what is the most common cause for diarrhea in the winter months
Rotavirus
vomiting for 3-4 days and diarrhea for 7-10
what are RF associated with salmonella infection
- infected domestic animals - lizards…
- contact with infected food - dairy, chicken
- Abx in the last month
- if on PPI/H block because salmonella killed by low PH
what organism causing diarrhea can be very dangerous for pt with IBD?
salmonella
leads to toxic megacolon
bacterial transloction
sepsis
what is the incubation time for salmonella?
FAST
6-72 hrs
what are the CF of salmonella infetction
- acute enteritis
- bacteremia - transient but can be severe
- extraintestinal focal ifections - meningitis, bone
when do we treat salmonella? and how
- if
what is the most common form of dysentery?
shigella
what causes of diarrhea will have leukoc
shigella salmonella Yersinia Campylobacter C.Diff Ecoli
what are CF of shigella infection?
look SICK fever severe abdo pain emeseis urgency and pain with stool GI: rectal prolapse, toxic mega, pseudomembraneous colitis hepatitis extraintestinal: Neuro, SIADH, hypoglycemia, sepsis eye involvemnt
how do you manage a shigella diarrhea
rehydrate VITAMIN A - high dose Zinc suppl high protein diet IV ceftriaxone if baby or PO cefixime for 5 days
what are the daycare exclusion for shigella
until 2 stool culture or rectal swabs negative
and diarrhea resolved
what are daycare exclusion for salmonella
24 hours post resolution of symptoms
how do you treat Entamoeba histolitica
flagyl
how do you treat Giardia?
Flagyl
what might cause severe diarrhea, very high temp and seizure?
shigella
which hepatitis can present acutely with jaundice and can look quite sick?
Hep B -AAP question
