Infections Flashcards
C. diff
this is a bacterial infection and the most common cause of healthcare associated diarrhoea
presentation of C. diff
- diarrhoea +/- blood
- abdominal pain
what can C. diff progress to?
- pseudomembranous colitis
- perforation
- toxic megacolon
diagnosis of C. diff
- screening for organism
- if positive then culture
management of C. diff
- isolate patient
- less severe= metronidazole
- severe= vancomycin
presentation of rotavirus
- D&V in children
- dehydration
diagnosis of rotavirus
PCR on faeces (sheds)
management of rotavirus
- rehydration, self limiting for about a week
- vaccine (live attenuated)
children can get post-infection Mal-absorption leading to more diarrhoea
presentation of norovirus
sudden onset D&V
diagnosis of norovirus
faeces and vomit swabs for PCR
management of norovirus
rehydration
define haemolytic uraemia syndrome (HUS)
affects the blood and blood vessels caused by E. coli0157 producing a verotoxin (can progress to kidney failure)
presentation of HUS
- abdominal pain
- fever
- pallor, petechiae and obliguria
diagnosis of HUS
- FBC
- renal function/creatinine
- stool culture
management of HUS
- dialysis
- blood transfusions
define gastroenteritis
infection caused by eating contaminated food
presentation of gastroenteritis
- diarrhoea and dysentery
- fever
- vomiting
- cholera “rice-water” like stools
diagnosis of gastroenteritis
- stool sample (all stools get salmonella, shigella, E. coli 0157, campylobacter and cryptosporidium and over 4 years gets C. diff)
- FBC
- AXR: thumbprint sign
management of gastroenteritis
- rehydration
- antidiarrhoeals e.g. bismuth chelate
define parasitic infection
infection with a parasite e.g. giardiasis lamblia (contaminated water)
presentation of giardiasis lamblia
abdominal pain, discomfort, nausea
significant malabsorption with weight loss and stearrhoea
diagnosis of giardiasis lamblia
stool examination for ova and parasites
management of giardiasis lamblia
metronidazole (1 week)
define enteric fever
this is caused by salmonella, paratyphoid and typhi (common in Indian subcontinent and SE Asia)
presentation of enteric fever
- fever
-headache - constipation or diarrhoea
- dry cough
can complication and progress to bleeding and encephalopathy
diagnosis of enteric fever
blood, urine and stool culture
management of enteric fever
- isolate patient
- ciproflaxacin, azithromycin, ceftriaxone (fluoroquinolone for resistance)
define Whipple’s disease
rare infection with tropheryma whipplei
presentation of Whipple’s
arthritis
arthralgia
weight loss
diagnosis of Whipple’s
positive PAS (tissue microscopy)
management of Whipple’s
trimethroprim
define Chaga’s disease
infection with trypanosome cruzi that causes parasympathetic depression
presentation of Chaga’s
- fever, fatigue, rash
- nausea, vomiting
can progress to myocarditis
diagnosis of Chaga’s
bloods for parasite or antibody
AXR, CXR
management of Chagas
remove parasite e.g. benznidazole
how does giving antibiotics in E. coli 0157 risk development of HUS
antibiotic injury to the cell membrane causes massive release of mediators
triad in HUS
haemolytic anaemia
AKI
thrombocytopenia
