Case 35: Bacterial Enteritis
Terms in this set (24)
If a child presents with fever, abdominal pain, and watery diarrhea that progressed to bloody diarrhea with mucous, what is the most likely diagnosis and a seizure, what is the most likely diagnosis?
What can be done to determine the diagnosis once bacterial enteritis is suspected?
Fecal leukocytes, fecal blood, and stool culture
What is the correct management for a Salmonella infection?
Salmonella infection is generally not treated because this can promote a chronic carrier state in the gallbladder unless the patient is younger than 3 months
What is the correct management for infection with Shigella?
Shigella is treated to shorten the illness and decrease organism excretion
Should antimotility agents be used in cases of bacterial enteritis?
What should be included in the differential for bloody stools in a child?
Meckels diverticulum, intussusception or volvulus, Henoch-Schonlein purpura, HUS, C. diff colitis, polyps, and bacterial enteritis
What is the definition of colitis?
Inflammation of the colon
What is the definition of dysentery?
Intestinal infection resulting in severe bloody diarrhea with mucus
What is the definition of enteritis?
Infection of the small intestine typically resulting in diarrhea
What are the characteristics of the Salmonella bacteria?
Salmonella are aerobic gram negative rods. They are motile and they do not ferment lactose. Infection is more common in warmer months
What are the two classifications of salmonella infections?
Nontyphoidal disease and typhoid
Exposure to what foods is a common source of salmonella infection?
Raw eggs and poultry
What animals can serve as a reservoir for salmonella?
Turtles and iguanas
What is the most common manifestation of nontyphoidal salmonella infection?
Gastroenteritis that typically presents as sudden onset of nausea, emesis, cramping abdominal pain, and watery or bloody diarrhea
What are the characteristics of the shigella bacteria?
Shigella are non-lactose fermenting small gram negative bacilli that are facultative anaerobes.
What are the four species of shigella that can cause disease in humans?
Shigella dysenteriae, bodii, flexneri, and sonnei.
How is infection with shigella typically transmitted?
From person to person, in contrast to salmonella
Are fecal leukocytes typically positive in cases of salmonella or shigella?
In a peripheral white count in a patient with shigella, what are the characteristic findings?
A normal white count with a remarkable left shift
What is the first strep in treatment in a child with severe diarrhea?
Fluid and electrolyte correction
What are some of the other organisms, besides salmonella and shigella, that can cause dysentery?
E. coli (EHEC), Campylobacter, and Yersinia enterocolitica
Which organism can cause pseudo-appendicitis?
Which organism can lead to HUS (hemolytic uremic syndrome)?
EHEC O157H7, or possibly salmonella or shigella
What is the classic triad of hemolytic uremic syndrome?
Hemolytic anemia, thrombocytopenia, and acute kidney failure