Infectious Diarrhea Flashcards
describe type 7 diarrhea
entirely liquid stool
describe type 6 diarrhea
mushy stool
Diarrhea is defined as _______ or more loose or liquid stools in 24 hours
3
prolonged diarrhea is how many days?
persistent diarrhea?
chronic diarrhea?
7-13
14-29
30 or more
dysentery diarrhea describes?
inflammatory diarrhea associated with blood and pus
watery diarrhea is typically caused by a ______ infection, commonly due to __________
viral, norovirus
bloody diarrhea is typically caused by a ______ infection, commonly due to __________
bacterial, c. diff, entamoeba, Yersinia, or E. coli
what are rare rxns from bloody diarrhea?
Guillain-barre syndrome
hemolytic uremic syndrome
toxic megacolon
reactive arthritis
when do we perform lab tests for infectious diarrhea?
bloody diarrhea
fever/signs of sepsis
diarrhea longer than 7 days
pt is immunocompromised
viruses are the most common cause of ____ diarrhea
acute
when is empiric antibiotic therapy indicates for diarrhea?
traveler’s diarrhea
bloody with fever and abdominal pain
infant under 3 months
immunocompromised patient
in the absence of signs and symptoms of inflammatory infection, you should suspect _____ infection and avoid _____
viral, antibiotics
do NOT use antibiotics in _____________ due to increased risk of hemolytic uremic syndrome
shiga-toxin producing E. coli
do NOT use antibiotics in shiga-toxin producing E. coli due to increased risk of _______________
hemolytic uremic syndrome
studies have shown that antibiotics may reduce symptom duration in adults with severe diarrhea by _____
1 day
what antimotility agents can be used and what type of diarrhea are they indicated for?
diphenoxylate, atropine and loperamide for watery diarrhea
antimotility agents should be avoided with _______________ and bloody diarrhea
shiga-toxin producing e. coli
norovirus is treated with? avoid?
rehydration, avoid antimotility agents
T/F there is a vaccine to prevent norovirus
false
T/F there is a vaccine to prevent rotavirus
true
what vaccines help prevent traveler’s diarrhea?
live cholera vaccine
hep A
salmonella (typhoid) vaccine
what OTC med can prevent traveler’s diarrhea, but is not commonly recommended?
bismuth subsalicylate
when do we consider prophylactic antibiotics to prevent traveler’s diarrhea?
immunocompromised patients on short-term travel
critical travel (military)
what is first-line tx for traveler’s diarrhea?
what about other options?
azithromycin
levo/ciprofloxacin
rifamycin
rifaximin
what should be in a travel kit to prepare for traveler’s diarrhea?
loperamide
thermometer
oral rehydration solution
water purification method
what is a good resource for travel medicine?
yellow book
what is the most common cause of foodborne illness in the US?
norovirus
a patient is diagnosed with foodborne illness after going to a new restaurant last week. The patient reported eating a salad with oysters. What is the most likely organism causing the symptoms?
a. Rotavirus
b. Clostridium perfringens
c. Norovirus
d. Clostridium botulinum
c
a patient is diagnosed with foodborne illness after going to a new restaurant last week. The patient reported eating clams for dinner and has bloody diarrhea. what is the most likely organism causing the symptoms?
a. Campylobacter
b. Norovirus
c. E. coli
d. Clostridium difficile
a
clostridium perfringens can cause foodborne illness from eating what?
a. unpasteurized dairy, clams, or dirty water
b. leafy greens, fruit, shellfish, or dirty water
c. Improperly canned or fermented foods
d. Beef, poultry, gravy, dried or precooked foods
d
clostridium botulinum can cause foodborne illness and is found in ______. A main symptoms is descending ______
honey, paralysis
_________ increases the risk of being exposed to salmonella
handling animals
unpasteurized milk, soft cheeses, raw sprouts, melons, hot dogs, deli meats, and smoked seafood have the risk of causing what foodborne illness?
listeria
what foodborne infection can lead to miscarriage, stillbirth and premature delivery?
listeriosis
which antibiotics have the highest risk of c. diff?
clindamycin
carbapenems
fluoroquinolones
cephalosporins
broad spectrum penicillins
what is the enzyme test for c. diff?
glutamate dehydrogenase
what is the PCR test for c. diff?
NAAT
Non-severe c. diff infection is a WBC ________ and SCr ________.
what are the antibiotics used?
< 15,000, < 1.5
First line: fidaxomicin
alt.: vanco
third line: metronidazole
Severe c. diff infection is a WBC ________ and SCr ________.
what are the antibiotics used?
> 15,000, > 1.5
first line: fidaxomicin
alt: vancomycin
Fulminant c. diff infection presents as hypotension or shock or megacolon and is treated with what antibiotics?
oral vanco AND IV metronidazole
when is a fecal microbiota transplant considered for a c. diff infection?
after 3 recurrent cases of C. diff
when is bezlotoxumab contraindicated for treating c. diff?
pt with CHF
