Infections

Question 1

Clostridium difficile
Cause
Symptoms
Management

Answer 1

Gram +ve rod.
Exotoxin causes pseudomembranous colitis.
Associated with clindamycin use.
Diarrhoea, abdominal pain, raised WCC, toxic megacolon.
Management: oral metronidazole for 10-14 days. If severe or not responding oral vancomycin.

Question 2

Campylobacter jejuni
Spread
Incubation
Symptoms
Management
Complications

Answer 2

Gram -ve bacillus.
Spread via faecal oral route.
Incubation 1-6 days.
Diarrhoea +/- blood, abdominal pain, prodrome: headache malaise.
Self limiting.
Antibiotics if immunocompromised, severe disease, for > 1 week.
Clarithromycin.
Complications: Guillain-Barre syndrome, reactive arthritis, sepsis, endocarditis.

Question 3

Norovirus
Incubation
Symptoms

Answer 3

Winter vomiting bug.

Incubation 15-30 hours. Nausea, vomiting, diarrhoea, headaches, low grade fever, myalgia.

Question 4

Gastroenteritis

Answer 4

Traveller’s diarrhoea- > 3 loose/watery stools in 24 hours +/- cramps, fever, nausea, vomiting, blood in stool.
Most common cause is E coli.

Question 5

Cholera

Answer 5

Profuse watery diarrhoea, severe dehydration leading to weight loss.

Question 6

Guilain-Barre syndrome
Cause
Symptoms

Answer 6

Immune mediated demyelination of peripheral nervous system triggered by infection, usually campylobacter jejuni.

Back/leg pain. Ascending weakness. Reflexes reduced. History of gastroenteritis. Respiratory muscle weakness. Cranial nerve involvement. Autonomic involvement- urinary retention.

Question 7

Gullain-Barre syndrome

Tests and management

Answer 7

LP- rise in protein, abnormal WCC
Nerve conduction studies- decreased conduction velocity due to demyelination.

IV immunoglobulin.

Question 8

Salmonella
Source
Incubation
Symptom

Answer 8

Slightly longer incubation of 6-72 hours, from contaminated eggs or milk. Can cause bloody diarrhoea.

Question 9

Rotavirus

Answer 9

Very similar to norovirus but predominantly in children < 5.

Question 10

E coli

Answer 10

Longer incubation of 3-4 days.

Question 11

Giardiasis vs shigella

Answer 11

Prolonged non bloody diarrhoea vs bloody diarrhoea