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GIHEP > L19: Food Poisoning > Flashcards

L19: Food Poisoning Flashcards

1
Q

What is food poisoning? (definition)

A

illness (gastroenteritis) caused by contaminated food

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2
Q

What are the symptoms of food poisoning?

A
  • diarrhea
  • vomiting
  • nausea
  • crampy abdominal pain
  • ± fever
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3
Q

What investigations/tests can be done if food poisoning is suspected?

A
  1. PCR of Faeces
  2. Blood Culture
  3. Test Food
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4
Q

Generally, what is the treatment for food poisoning?

A
  • supportive treatment

- antibiotics typically not indicated

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5
Q

Explain the toxin involved and the characteristics of food poisoning caused by S. aureus

A
  • heat stable enterotoxin ingested
  • works fast [within 1 to 8 hours]
  • lasts 8-24 hours
  • vomiting predominates
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6
Q

What is the clinical presentation of food poisoning by S. aureus?

A
  • works fast [within 1 to 8 hours]
  • lasts 8-24 hours
  • vomiting predominates, occasionally diarrhea
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7
Q

What is Type 1 of Bacillus cereus food poisoning?

A

Type 1 = Emetic Syndrome

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8
Q

What is Type 2 of Bacillus cereus food poisoning?

A

Type 2 = Diarrheal Syndrome

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9
Q

How does Bacillus cereus cause type 1 emetic syndrome? (toxin/spore involved?)

A
  • spores germinate in food and release toxin
  • ingestion of performed toxin
  • e.g. fried rice
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10
Q

What is the clinical presentation of food poisoning by B. cereus type 1?

A
  • works fast [within 1 to 6 hours]
  • lasts 2-10 hours
  • predominantly vomiting + abdominal cramps
  • may have diarrhea
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11
Q

How does Bacillus cereus cause type 2 diarrheal syndrome? (toxin/spore involved?)

A
  • spores ingested in food (not toxin)

- toxin production (in vivo) after spores germinate

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12
Q

What is the clinical presentation of food poisoning by B.cereus type 2?

A
  • incubation period between 6 to 14 hours
  • lasts between 8 to 24 hours
  • predominantly diarrhea
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13
Q

How does Clostridium perfringens cause food poisoning? (spores/toxin involved?)

A
  • ingestion of heat-resistant spores

- toxin production in-vivo

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14
Q

What is the clinical presentation of food poisoning by C. perfringens?

A
  • incubation period between 8-24 hours
  • lasts 1-3 days
  • profuse diarrhea, occasionally vomiting
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15
Q

How does Clostridium botulinum cause food poisoning? (spores/toxin involved?)

A
  • ingestion of neurotoxin
  • improperly canned/home bottled products
  • toxin binds irreversibly to pre-synaptic nerve endings and inhibits ACh release
  • get paralysis
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16
Q

What is the clinical presentation of food poisoning by C. botulinum?

A
  • incubation between 12 and 36 hours
  • acute descending symmetrical weakness
  • paralysis
  • high mortality
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17
Q

What is the treatment of food poisoning by C. botulinum?

A

treat w/ antitoxin

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18
Q

What organism is the most common cause of food poisoning in developed countries?

A

Campylobacter spp.

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19
Q

What are the 4 types of campylobacter spp. that may cause food poisoning? Which is the most common?

A
  1. C. jejuni = most common
  2. C. coli
  3. C. fetus
  4. C. lari
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20
Q

What is the main source of campylobacter spp. which causes food poisoning?

A
  • undercooked meat and meat products*
  • – inadequate decontamination
  • raw or contaminated milk

*cases peak in summer months/barbecue season

21
Q

What is the clinical presentation of food poisoning cause by campylobacter spp.?

A
  • incubation period of 2-4 days (can be up to 8-9 days)
  • prodromal illness (fever, headache)
  • diarrhea (may be bloody)
  • abdominal pain
  • resolves w/in 5 to 7 days
22
Q

List the complications after food poisoning by campylobacter spp

A
  • toxic megacolon
  • bacteraemia
  • Guillain-Barre Syndrome
23
Q

What investigations can be done to diagnose food poisoning caused by campylobacter spp.

A
  • PCR (of faeces)

- Culture (of faeces or blood)

24
Q

List all the laboratory features of the campylobacter species

A
  • gram negative (curved) bacilli
  • positive oxidase test
  • hydrolyses hippurate (makes a blue colour)
  • greyish colonies on selective charcoal-containing media incubated in CO2 at 42 degrees
25
Q

Which organism will produce greyish colonies on selective charcoal-containing media incubated in CO2 at 42 degrees?

A

Campylobacter spp.

26
Q

Which organism hydrolyses hippurate?

A

Campylobacter spp.

27
Q

What is the treatment of food poisoning caused by Campylobacter spp.?

A
  • typically rehydration

- antibiotics only given if bacteraemic or immunosuppressed (azithromycin or ciprofloxacin)

28
Q

In specific cases, antibiotics may be given to treat food poisoning caused by Campylobacter spp - what antibiotics may be given?

A

Azithromycin or Ciprofloxacin

29
Q

What is another name for enterohaemorrhagic E. coli (EHEC)?

A

Verotoxigenic E. coli (VTEC)

30
Q

What is the main reservoir of enterohaemorrhagic E. coli and what are the modes of transmission?

A
  • main reservoir = cattles

- transmitted through beef products, contact w/ animals or faeces and person-to-person

31
Q

What is the most common serotype of enterohaemorrhagic E. coli?

A

E. coli O157:H7

32
Q

Where in the GIT does enterohaemorrhagic E. coli affect?

A
  • colon
  • adheres + invades intestinal epithelial cells
  • causes cell death and bloody diarrhea
33
Q

What is the clinical presentation of enterohaemorrhagic E. coli food poisoning?

A
  • incubation b/w 1 to 10 days (median = 3)
  • bloody diarrhea
  • lasts 3 days
34
Q

What is the main complication of food poisoning caused by enterohaemorrhagic E. coli?

A

Haemolytic Uremic Syndrome

35
Q

What organism causes Traveller’s Diarrhea?

A

enterotoxigenic E. coli

36
Q

What is the clinical presentation of food poisoning caused by enterotoxigenic E. coli?

A
  • incubation b/w 1 to 3 days
  • watery diarrhea, fever, nausea
  • self limiting
  • lasts 1-5 days
37
Q

What 2 toxins are involved in food poisoning caused by enterotoxigenic E. coli?

A
  1. Heat Labile Toxin

2. Heat Stabile Toxin

38
Q

Where in the GIT does enterotoxigenic E. coli affect?

A

small GIT - does not invade

39
Q

What organism is the major cause of infantile gastroenteritis?

A

Enteropathogenic E. coli

40
Q

Where in the GIT does enteropathogenic E. coli affect?

A

small GIT

41
Q

What is the clinical presentation of infantile gastroenteritis caused by enteropathogenic E. coli?

A
  • watery diarrhea
  • vomiting
  • fever
42
Q

Which organism that causes food poisoning can also grow in refrigerated foods?

A

Listeria monocytogenes

43
Q

Explain how an early-onset neonatal listeria infection is acquired and how it presents

A
  • acquired in utero
  • presents w/ BSI
  • HIGH mortality (compared to late onset)
44
Q

Explain how late-onset neonatal listeria infection is acquired and how it presents

A
  • acquired from maternal genital tract during birth
  • presents w/ meningitis or meningoencephalitis
  • more common than early onset
45
Q

Is early-onset or late-onset neonatal listeria infection more common?

A

late-onset

46
Q

What is the treatment of a listeria monocytogenes infection?

A

high dose ampicillin/amoxicillin

w/ an aminoglycoside (e.g. gentamicin)

47
Q

What is the clinical presentation of infection with a cryptospordium spp infection?

A
  • symptoms begin 2-10 days after infection

- watery diarrhea

48
Q

What is the main mode of transmission of cryptosporidium spp?

A
  • faecal-oral
  • faecally contaminated food or WATER sources
    • resistant to chlorine-based disinfectants
49
Q

What special stain is used to detect cryptosporidium spp under a microscope?

A

modified acid-fast stain or auramine

GIHEP (24 decks)

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