- abrupt diarrhea, vomiting - "rice water stool" up to 24 L per day (yellowish--probably mucin)

live attenuated vaccine; - Efficacy in US >90% - Efficacy in developing countries 17-65%

Infectious Diarrhea Flashcards by k k

Leading 2 causes of death worldwide

pneumonia, diarrhea

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leading cause of morbidity and death

Dehydration

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important part of therapy for dehydration/diarrhea

Rehydration

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Most common cause of infectious gastroenteritis in US

unknown!! (40%)

Viral (30-40%)
Bacterial/Parasitic (20-30%)

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GI site implicated in non-inflammatory diarrhea

upper small bowel

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GI site implicated in inflammatory diarrhea

colon

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what might labs show in inflammatory diarrhea

increased T cells, WBC, RBC

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pathogens causing Non-inflammatory diarrhea

vibrio cholerae, Norwalk, Rotavirus, ETEC, Giardia

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Inflammatory diarrhea pathogens

C. JEJUNI, Shigella, Salmonella, E. coli O157:H7, C difficile, E. histolytica

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What makes cholera infectious

Toxin (A:5B)

- similar to ETEC

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symptoms of cholera

abrupt diarrhea, vomiting

- “rice water stool” up to 24 L per day (yellowish–probably mucin)

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how does cholera affect mucosa

binds epithelial cells and causes secretion – not really harming epithelium

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incubation period of cholera

18h - 5 days

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Blood in cholera diarrhea?

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Oral rehydration solution

water, a little salt, carbohydrate (sugar)

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what infectious agent similar to cholera toxin?

ENEC - enterotoxic E coli

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What is the leading cause of prolonged diarrhea

Rotavirus

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Leading cause of dehydration from diarrhea

Rotavirus

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leading cause of hospitaliziation from diarrhea

Rotavirus

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Leading cause of death from diarrhea (US and world)

Rotavirus (due to prolonged diarrhea and dehydration)

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Rotavirus vaccine

live attenuated vaccine;

Efficacy in US >90%
Efficacy in developing countries 17-65%

Incubation pd and duration of illness of rotavirus

1-3 days incubation; duration 5-8 days usually

age mostly affected by rotavirus

infants, young children

age mostly affected by norwalk virus

older children adults

Norwalk transmission

fecal-oral, contaminated. | - shellfish and water

Rotavirus transmission

fecal-oral

Epidemiology of rotavirus

sporadic cases, usually winter, occasionally epidemic

Norovirus epidemiology

family and community epidemics, often winter; comes on fast/goes away fast

incubation pd and duraiton of norovirus

1-2 days incubation and 1-2 day duration

therapy for norovirus/rotavirus

none really; vaccine work on rotavirus

giardia

eukaryote --protozoan

Giardia symptoms

diarrhea, fatigue, abdominal cramps, gas, fatty stool, stomach makes noises

cause of most hemorrhagic colitis in US

E coli O157:H7

E coli O157:H7 population affected/duration

lasts 2-4 days (

source of E coli O157:H7

mostly meat

symptoms of E coli O157:H7

- large spectrum of illness - asymptomatic - nonbloody diarrhea - hemorrhageic colitis - Hemolytic uremic syndrome (HUS) - thrombocytic thrombocytopenic purpura (TTP)

what makes E coli O157:H7 so bad

toxin!

what happens when you give antibiotics to someone with E coli O157:H7

lyse cells so that toxin released...more toxin production?

Nosocomial diarrhea definition

-hospital-acquired; >3 days in hospital

leading cause of nosocomial diarrhea

C. difficile

reason for C difficile infection

disruption of normal microbiota-- most commonly associated with antibiotic use

C difficile symptoms

mild diarrhea, watery or bloody, may have fever, leukocytosis with severe colitis

Therapy for C difficile

antibiotics, recurrence (15-26%)-- bug can persist and you have knocked out all other bugs in GI--hard to get balance back - Fecal transplant if a few rounds - working on pills of fecal microbiota

#1 cause of traveler's diarrhea

Enterotoxic E coli

No fever suggests what kind of diarrhea?

non-inflammatory diarrhea

when diarrhea doesn't respond to antibiotics consider what org?

Giardia

grossly bloody diarrhea without fever suggests what org

E coli O157:H7

E. coli O157H7 toxin

Verotoxin; shiga-like toxin (SLT-I/II) - binds especially to human renal endothelial cells - inhibits protein synthesis

Therapy of E. coli 0157H7

TMP/SMX- all sensitive - IV Ig? - Prevention (food, cooking)

Enteric Fever

Site: Nodes, blood, gallbladder | - Pathogens: Salmonella typhi, paratyphi, +/- Yersinia

Typhoid fever

- caused by Salmonella enteric serotype typhi - Gram (-) rod; human only - risks: fecal contamination, food/water (poor handling), contact with carrier