Infectious Diarrhoea Flashcards
1
Q
What is the epidemiology of gastroenteritis?
A
- affect 25% of population each year
2
Q
What is the cause of gastroenteritis?
A
- food contamination
- intensively farmed chickens
- campylobacter (most common bacterial pathogen)
- poor storage of produce
- bacterial proliferation at room temp.
- travel related infections
- e.g. salmonella (causes most hospital admissions)
- person-to-person spread
- norovirus
3
Q
What are the different clinical types of diarrhoeal illness?
A
- non-inflammatory/secretory
- e.g. cholera
- inflammatory
- e.g. shigella dysentery
- mixed picture
- e.g. C. difficile
4
Q
What are the features of non-inflammatory?
A
- secretory toxin-mediated
- cholera- inc cAMP levels + Cl secretion
- enterotoxigenic E. coli
- frequent watery stools
- little abdominal pain
- rehydration main therapy
5
Q
What are the features of inflammatory?
A
- inflammatory toxin damage + mucosal destruction
- bacterial infection/amoebic dysentery
- pain + fever
- rehydration
- antimicrobials
6
Q
How are electrolytes lost?
A
- hyponatraemia- Na lost with fluid
- replace by hypotonic solutions
- hypokalaemia- K lost in stool
7
Q
What are the investigations for gastroenteritis?
A
- stool culture (+ molecular or Ag testing)
- blood culture]
- renal function
- blood count
- XR/CT
8
Q
What are the features of campylobacter gastroenteritis?
A
- diatery history unreliable (up to 7 days incubation)
- severe abdominal pain
- post-infection sequelae
- Guillian-Barre syndrome, reactive arthritis
9
Q
What are the features of salmonella gastroenteritis?
A
- symptoms onset < 48hrs after exposure
- diarrhoea < 10 days
- post-infectious IBS common
10
Q
What are the features of E. coli 0157?
A
- frequent bloody stools
- produces shigella toxin- gets into blood
- toxin can cause Haemolytic-Uraemic Syndrome (HUS)
11
Q
What are the 4 antibiotics that commonly cause C. difficile infection?
A
- Cephalosporins
- Co-amoxiclav
- Clindamycin
- Ciprofloxacin
12
Q
What is the treatment for Clostridiodes Difficile?
A
- metronidazole
- oral vancomycin
- fidaxomicin
- stool transplants
- surgery
