Lecture 9.2: Infections of the Gastrointestinal Tract Flashcards
1
Q
Travellers’ Diarrhoea (TD) is the occurrence of three or more unformed stools in a 24 hour period, accompanied by one or more of the following……during or after travel (6)
A
- Fever
- Nausea
- Vomiting
- Abdominal Cramps
- Tenesmus
- Bloody stools
2
Q
When do Symptoms of Travellers’ Diarrhoea Start and Stop?
A
- 6–7 days after arrival
- Usually resolve spontaneously after 3 or 4 days
3
Q
What parts of the world have a 60% chance of TD occurring?
A
- Latin America
- Africa
- Indian Subcontinent
4
Q
What does NHS Fit for Travel recommend to reduce risk of TD? (2)
A
- Good Hygiene Measures
- Bismuth subsalicylate if required for prophylaxis
5
Q
What are Common Causative Agents of Traveller’s Diarrhoea? (6)
A
- Enterotoxigenic E.coli
- Campylobacter jejuni
- Shigella
- Salmonella
- Cryptosporidia
- Entamoeba histolytica
6
Q
Why is prescribing Ciprofloxacin for treatment and prevention TD not ideal?
A
- Broad spectrum fluoroquinolone
- Disturbs the natural flora of the gut
- Risks creating reservoirs of antibiotic resistant genes
in gut commensals, can be transmitted horizontally
7
Q
Why is Clindamycin Clinically Significant?
A
- Causes Antibiotic-Associated Diarrhoea
- Causes Pseudomembranous colitis
- Caused by suppression of the normal gut flora, which
allows Clostridium difficile to multiply
8
Q
Why is Clostridium difficile clinically significant?
A
- Produces enterotoxin & cytotoxin
- Causes toxin-mediated damage to gut wall
- Often severe, may be rapidly fatal
9
Q
What antibiotics can be used to treat C.difficile?
A
- Antianaerobic metronidazole
- Or oral vancomycin – but vanco should be
avoided where possible
10
Q
How can recurrent or refractory C.difficile be treated?
A
- Faecal Transplant
- Faeces are diluted with water/ saline/ yoghurt/ milk
- Introduced to recipient’s gut via nasogastric tube,
nasoduodenal tube, rectal enema or via the biopsy
channel of a colonoscope
