21 terms

Acute gastroenteritis

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Describe the enteric pathogens, sources, duration and effects
What bugs CANNOT be treated with Cipro
Campylobacter (azithro)
Vibrio/Shiga producing E coli (no tx)
C Diff (Flagyl)
Giardia Lamblia (Flagyl)
Mycoses/ameobas
Indications for obtaining stool cultures
Significantly ill
Febrile
Significant comorbid disease
Bloody stool
Recent Abx use
Strongly suspected reportable disease
List 4 types of diarrhea and give an example of each
Osmotic -- solutes draw water in (PEG, sorbitol, colchicine) - stops with agent
Secretory -- Barrier affected and allows leaking (pathogen) -- does not stop with fasting
Inflammatory -- MM damage leading to secretion (infn, chemo, rad, IBD)
Abnormal motility -- chronic diarrhea
What % of diarrhea is infectious and what are the etiologies
85% infectious
60% viral
20% bacterial
5% parasitic
Name 5 causes of non-infectious diarrhea
Drugs (antichol)
Obstruction
Short gut
Hyperthyroid
Carcinoid
Adrenal insuff
Alcoholism
Lymphoma
HUS/HSP
What is the most common cause of bacterial enteritis
CAmpylobacter
Name 3 subtypes of campylobacter
C jejuni
C Coli
C fetus
What bacterial pathogens most mimic appendicitis
Campylobacter
Yersinia
List 5 complications of Campylobacter enteritis
GBS
Cholecystitis
Pancreatitis
GI heamorrhage
Meningitis
Endocarditis
Which patients are more prone to systemic salmonella septicemia
SC disease
AIDS
Infants
AGE > 65
on PPI
Leukemia
Lymphoma
Name 5 causes of toxin induced enteritis
Staphylococcus (preformed)
Scombroid (preformed)
Ciguatera (preformed)
C perfringens (after colonization)
C diff (after colonization)
Vibrio (after colonization)
What is the main source of bacillus cereus toxin mediated diarrhea
Uncooked rice or labile spore on cooked rice stored at room temp
What causes cholera
Vibrio cholerae - inadequately cooked shellfish
What are Scombroidodera
A Genus subtype of dark meat fish
Tuna, Mackerel, Mahi Mahi, Blue fish, swordfish, amberjack
What is pathophys of scombroid
Ingestion of heat labile toxin made by commensal bacteria of the fish
Histadine decorboxylase produces histamine and histamine-like substance - massive histamine surge
Caused by improper preservation of refrigeration
What are symptoms and onset
Onset within 20-30 minutes
Peppery metallic taste
Flushing, diarrhea, headache, palpitations, cramps
Tx are histamine blockers
Clinical features of ciguatera poisoning
What is the most common cause of diarrhea in patients with AIDS and CD4 < 200
Cryptosporidium
Extensive fluid losses are seen in these patients (3-10L per day)
List the causes of Diarrhea in AIDS patients
What is the most common cause of travellers diarrhea
ETEC