Tropical Gastroenteritis Flashcards
What is the most common organism that causes acute travellers diarrhoea?
E.coli.
What is the definition of travellers diarrhoea?
3 loose stools in 24 hours.
What investigations would you do for acute travellers diarrhoea?
Stool culture/microscopy.
What antibiotics may you give for acute travellers diarrhoea?
Fluoroquinolone or macrolide.
Where does enteric fever tend to come from?
Indian subcontinent/SE Asia.
What are the symptoms of enteric fever?
Fever, headache, constipation/diarrhoea, dry cough.
What are the potential complications of enteric fever?
GI bleeding, GI perforation, encephalopathy, bone and joint infection.
What is the antibiotic given for enteric fever?
IV ceftriaxone.
What is the organism that causes amoebiasis?
Entamoeba histolytica (protozoa).
What are the symptoms of amoebic dysentery?
Abdominal pain, fever, bloody diarrhoea/colitis, peritonism.
What investigations would you do for amoebiasis?
Stool microscopy, AXR (toxic megacolon), endoscopy for biopsy.
What is the incubation period for amoebic liver abscess?
8-20 weeks.
What is the clinical presentation of amoebic liver abscess?
Fever/sweats, upper abdominal pain, sometimes history of GI upset (dysentery), hepatomegaly, point tenderness.
What should you exclude before aspirating an amoebic liver abscess?
Hyatid disease.
What is the management of amoebic liver abscess?
Metronidazole or tinidazole.
Paramomycin/diloxanide to clear gut lumen of parasites.
What organism causes giardiasis?
Giardia intestinalis (flagellated protozoa).
What is the incubation time for giardiasis?
Around 7 days.
What is the clinical presentation of giardiasis?
Watery/malodorous diarrhoea, bloating and flatulence, abdominal cramps, weight loss.
What investigations would you do for giardiasis?
Stool microscopy for cysts (or PCR), OGD for duodenal biopsy (rarely necessary).
What is the treatment of giardiasis?
Metronidazole or tinidazole.
What is the most common helminth infection in the world?
Ascariasis (intestinal nematodes).
What is the life cycle of ascariasis?
Breaks through gut wall into venous system where it invades lungs, climbs up trachea and gets swallows again.
Give 3 examples of flukes.
Schistosomiasis.
Liver flukes - clonorchis/fasciola (SE Asia).
How does chronic schistosomiasis infection cause liver fibrosis and portal hypertension?
Adult worms located in portal venules.
