GI - Causes Of Gastroenteritis And Incubation Periods

Question 1

E. coli: Typical presentation

Answer 1

• Common amongst travellers
• Watery stools
• Abdominal cramps and nausea
• Incubation period 12-48h
• Treatment: do not treat if suspect E Coli 0157, will only worsen situation

Question 2

Giardiasis: typical presentation and treatment

Answer 2

• Caused by flagellate protozoan Giardiasis Lamblia - spread faeco-oral route
• Often asymptomatic
• Lethargy, bloating, abdominal pain, non-bloody diarrhoea
• Incubation period > 7 days
• Treatment: metronidazole

Question 3

Cholera: typical presentation and treatment

Answer 3

• Profuse, water diarrhoea
• Severe dehydration resulting in weight loss
• Not common amongst travellers
• Aggressive IV fluid rehydration + Doxycycline if very unwell

Question 4

Shigella: typical presentation and treatment

Answer 4

• Bloody diarrhea
• Vomiting and abdo pain
• Incubation period 48-72h
• Treatment: ciprofloxacin

Question 5

Staphylococcus aureus: typical presentation

Answer 5

• Severe vomiting

- Short incubation period 1-6h

Question 6

Campylobacter: typical presentation, complications and treatment

Answer 6

• Flu like prodrome, usually followed by crappy abdominal pains, fever and diarrhoea which may be bloody
• May mimic appendicitis
• Complications include Guillain-Barre’ syndrome
• Incubation period is 48-72h
• Clarithromycin

Question 7

Bacillus cereus: association and typical presentation

Answer 7

Two types of illness are seen

• Vomiting within 6h, stereotypically due to rice
• Diarrhoeal illness occurring after 6 hours

Question 8

Amoebiasis: typical presentation

Answer 8

• Gradual onset bloody diarrhoea, abdo pain and tenderness which may last for several weeks.
• Incubation period >7 days

Question 9

MRSA: how do you do MRSA suppression from a carrier once identified?

Answer 9

• Nose: mupirocin 2% in white soft paraffin, TDS for 5 days

- Skin: chlorhexidine gluconate OD for 5 days - apply all over especially to axilla, groin and perineum

Question 10

What antibiotics are used for MRSA treatment?

Answer 10

• Vancomycin
• Teicoplanin
• Linezolid

Question 11

What antibiotics should we avoided to use alone when treatment MRSA (to avoid resistance development)

Answer 11

• Rifampicin
• Macrolides
• Tetracyclines
• Aminoglycosides
• Clindamycin

Question 12

Clostridium difficile: recommended treatment

Answer 12

• First episode: metronidazole

- Second or subsequent episode: vancomycin