Inflammatory Diarrhea Flashcards
Inflamm Diarrhea
Loose watery stools, smaller in volume plus PMNs; usually invasive infection of LI. Mucus and Blood present, abd cramps. (Occult blood = blood that’s not visible)
Dysentery
Inflammation of colon resulting in abd pain and cramps, straining stools with tenesmus. Watery diarrhea/loose stools containing PMNs, blood and mucus
Bacterial Path
Bacteria enter via endocytosis by M cells found in Peyer’s patches (SI) and migrate via lamina propria or cell to cell to LI or be endocytosed via cells w/in the lymphoid aggregates in LI.
Shigella Spp. Clin
Shigellosis/ Bacillary Dysentery/ Inflamm Diarrhea - large volumes diarrhea progressing to small volume with blood and tenesmus. May develop shallow intestinal ulcers. Alters Electrolyte balance
Shigella Spp. Char
Gram neg rod, four groups : Sonnei, Dysenteria, Flexneri, Bovdii. S and D most prevelent
Shigella Spp. Res
Humans only
Shigella Spp. Trans
Fecal Oral
Shigella Spp. RF
Pediatric; close quarters
Shigella Spp. Diag
Hektoen agar - green colonies; lactose negative
Shigella Spp. Toxins
- ShET 1 and ShET 2 (chromosome and plasmid) = early watery diarrhea
- S. Dys serotype produces Shiga toxin (AB) which inhibs protein synth by inact 60s ribosome subunit, synergizes with LPS to produce inflamm cytokines causing dmg to endothelium lining blood vessels. Assoc with progression to HUS
Shigella Spp. Comp/Seq
HUS in children and Reactive arthritis in those with HLA-B27
Enteroinvasive E. Coli Clin
Inflamm Diarrhea
Enteroinvasive E. Coli Char
Gram neg rod
Enteroinvasive E. Coli VF
Rearranges host cell actin for intracell mvmt and cell to cell infection
Enteroinvasive E. Coli Res
Humans and Animals
Enteroinvasive E. Coli Trans
Fecal-Oral
Enteroinvasive E. Coli RF
Anyone; ground beef
Enteroinvasive E. Coli Diag
Lactose pos, indole pos
Salmonella Enterica spp. Clin
Salmonellosis = Inflamm diarrhea, small volume diarrhea and occult blood
Salmonella Enterica spp. VF
- SopE gene protein - increases cAMP
2. SopB gene protein - actin rearrangement; host cell invasion
Salmonella Enterica spp. Res
Animals - poultry, dairy, reptiles
Salmonella Enterica spp. Trans
Fecal Oral
Salmonella Enterica spp. RF
Eggs
Salmonella Enterica spp. Diag
Hektoen - black colonies via H2S, lactose neg
Salmonella Enterica spp. Comp/Seq
Reactive Arthritis (HLA-B27)
Campylobacter Jejuni Clin
Campylobacterosis = Inflamm Diarrhea (10+per day)
Campylobacter Jejuni Char
Gram neg comma shaped rod
Campylobacter Jejuni Res
Animals - poultry, pets, human carries
Campylobacter Jejuni RF
young and Icomp; unpasteurized milk
Campylobacter Jejuni Diag
Culture at 42C
Campylobacter Jejuni Seq/Comp
Gullian-Barre Syndrome - ascending flaccid paralysis Reactive Arthritis (HLA-B27)
Yersinia Enterocolitica Clin
Inflamm diarrhea +/- blood
Yersinia Enterocolitica Char
gram neg rod w/ bipolar staining
Yersinia Enterocolitica Res
Animals, milk, pork, pets, chitlins
Yersinia Enterocolitica Trans
Fecal Oral, transfusions
Yersinia Enterocolitica RF
Dairy, pork, serious disease seen primarily in children
Yersinia Enterocolitica Diag
Grow at 4C
Yersinia Enterocolitica Comp/Seq
- Mesenteric lymphadentitis/pseudoappendicitis in adolescents/young adults
- Reactive Arthritis (HLA-B27)
- Bacteremia can occur with progression of disease or if infection is transmitted through transfusion
Entameoba Histolytica Clin
Amoebiasis = Amoebic dysentery - Inflamm diarrhea with blood. Serious Disease leads to ulceration of LI (flask shaped lesions) and liver abscesses (RUQ pain)
Entameoba Histolytica Char
Ameoboid protozoan
Entameoba Histolytica Res
Human carriers; cysts can survive in soil and water
Entameoba Histolytica Trans
Fecal Oral
Entameoba Histolytica Diag
Cysts or motile trophozoites (visualized engulfed RBCs help) in stool. Followed by Elisa assay for Ag
Entameoba Histolytica Tx
Amebicides
