GI Infections Flashcards
Organisms causing Secretory diarrhoea
Bacillus cereus, staph aureus, E. coli, Cholera
BSEC
Organisms causing inflammatory (bloody) diarrhoea
Campylobacter jejuni
Haemorrhagic E. Coli (EHEC)
Entamoeba histolytica
Salmonella enteritides
Shigella
CHESS
Diarrhoea same day after eating reheated rice
Bacillus cerus (Gram+ve Rod)
Vomiting and watery diarrhoea
Self-limiting
Diarrhoea 2hrs after eating suspicious food
Staph aureus
Vomiting, watery diarrhoea
Self-limiting
Diarrhoea after travelling
Enterotoxigenic E. Coli (ETEC)
Self-limiting
Gram-ve
Rice water stool, comma-shaped bacteria
Vibrio cholera (gram-ve)
Self-limiting
Africa/Middle-east
Diarrhoea after chicken at a BBQ, prodrome of fever and headache, abdo cramps, bloody diarrhoea lasting 10 days
Campylobacter jejuni (Gram-ve)
Erythromycin if in first 5 days
2-4 day incubation period
Diarrhoea 12hrs after eating poultry and eggs
Salmonella enteritides
Non bloody diarrhoea
Self-limiting, ceftriaxone if required
Descending paralysis after eating uncooked beans or an infant eats honey
Clostridium botulinum - cleaves SNARE proteins to prevents Ach release from peripheral nerves
Mx: Antitoxin
Water diarrhoea after eating reheated meat & cramps, lasting 24hrs
Clostridium Perfringens
Can cause gas-gangrene
Bloody diarrhoea, flatulence, tenesmus with flask-shaped ulcer on histology. RUQ pain, weight loss, fevers (liver abscess), 4 nuclei
Entamoeba histolytica
Mx: metronidazole
Foul-smelling non-bloody diarrhoea, pear-shaped trophozoite in immunocompromised, 2 nuclei
Giardia Lamblia
Most common protozoal intestinal infection
Metronidazole
Severe prolonged diarrhoea in immunocompromised. Kinyoun Acid Fast Stain
Cryptosporidium Parvum (protozoa)
Mx: Paromomycin
Secretory diarrhoea in <2yo or immunocompromised
Adenovirus - self-limiting
Secretory diarrhoea in <6yo at nursery
Rotavirus
Secretory diarrhoea & V outbreak in adults, self-limiting
Norovirus
Constipation, fever, rose spots, splenomegaly in a returning traveller
Salmonella Typhi/Paratyphi (Typhoid fever)
Mx: IV Ceftriaxone then PO azithromycin
Severe diarrhoea following a course of Abx
C. difficile (caused by 3C’s - cephalosporins, ciprofloxacin, clindamycin)
1st line: PO Vancomycin, stop Abx where possible
(Pseudomembranous colitis)
Mucosal inflammation, bloody diarrhoea, abdo pain, fever after eating poultry
Shigella
Self-limiting
Bloody diarrhoea & HUS
EHEC 0157 (shiga-toxin)
Common cause of infantile diarrhoea
EPEC (enteropathogenic E. coli)
