2: Infections of GI tract Flashcards by Grace Poole

Define gastroenteritis

Diarrhoea cause by infection of GI tract with bacteria, virus or parasite

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Define diarrhoea

More than 3 episodes of partially formed watery stool for <14d

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Define dystentry

Infective gastroenteritis with blood

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What is persistent diarrhoea

Diarrhoea >14d

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What 6 infections are know to cause dysentry

SECCSY (Sexy)

Salmonella
E.Coli
Campylobacter jejuni
Clostridium difficile 
Shigella
Yersinia

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What bacteria have an incubation period of 1-6h

Staph.A

Bacilleus Cereus

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What bacteria have an incubation period 12-48h

E.Coli

Salmonella

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What bacteria have an incubation period of 48-72h

Campylobacter.J

Shigella

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What two organisms have an incubation period for more than 7 days

Giardiasis

Amoebiasis

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What are two risk factors for Norovirus

Contact with infected food, person or surface

2. Outbreaks in hospitals

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What is the incubation period of norovirus

12-48h

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How will norovirus present clinically

Acute-onset vomiting and watery diarrhoea

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When is norovirus infection common

Winter outbreaks at hospitals and nursing homes

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What type of organism is norovirus

ssRNA

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how is norovirus diagnosed

Clinically

rt-PCR

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how is norovirus infection managed

Oral rehydration solution

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In which population is rotavirus infection more common

Most common cause of gastroenteritis in children

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How will rotavirus present clinically

Vomiting and diarrhoea

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What is the incubation period of rotavirus

1-3d

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How is rotavirus investigated for

Clinical

ELISA Stool toxin

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What is used to manage rotavirus

Oral rehydration solution

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How can rotavirus be prevented

Oral live-attenuated vaccine given at 2,3m as part of immunisation schedule in the UK

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What food substance can cause clostridium pefringens infection

Undercooked meat
Refrigerated meet
Legumes

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What is the incubation of clostridium pefringens

6-24h

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How does clostridium pefringens present clinically

Crampy abdominal pain and watery diarrhoea

What organism is clostridium pefringens

Gram positive anaerobe

What is a complication of clostridium pefringens

B toxin - can cause necrotising fulminant enterocolitis. Presents as abdominal pain, bloody diarrhoea and sepsis.

Where is bacillus cereus obtained from

re-heated rice

What are two sources of cholera

- Contaminated water | - Undercooked sea-food

How will cholera present clinically

Rice-water stools Vomiting Low-grade fever

What type of organism is cholera

Gram negative

How can cholera be diagnosed

Rapid stool test | MC+S

What is first-line to manage cholera

Oral rehydration solution. If severe, IV fluids

If severe, what antibiotics may be given in cholera

Doxycycline | Tetracycline

What is given to children with cholera and why

Zinc - as this shortens disease duration

What is a major complication of cholera

Major dehydration. Anyone with watery diarrhoea >5 who died in an known epidemic is diagnosed as having cholera

What is the incubation period of Giardiasis

>7d

How can Giardiasis infection be differentiated from Amoebiasis infection

Giardiasis has diarrhoea without blood. Whereas, amoebiasis has dysentry

How does shigella present clinically

Dystentry Tenesmus Fever

What type of organism is shigella

Grame negative

How can shigella be investigated

Stool Culture

What is shigella managed

Oral rehydration solution | Green bananas or zinc if under 6-years

What is given to children under 6 with shigella

Zinc

What are three complications of shigella infection

Haemolytic Uraemic Syndrome Reactive arthritis Bacteraemia

Where is enterohaemorrhagic E.coli obtained from

Undercooked meat

How will EHEC present

Diarrhoea | Haemorrhagic colitis

How is EHEC diagnosed

Stool MC+S

Why should antibiotics not be given for EHEC

Increases risk of HUS

What is the most common cause of haemolytic uraemia syndrome

Shiga toxin produced by EHEC:O157: H7

What are two sources of campylobacter jejuni

Unpasteruised milk | Undercooked meat

How does campylobacter jejuni infection present

Dysentry Headache Low grade fever

What type of organism is campylobacter

Gram negative

how is campylobacter investigated

Stool MC+S

what is a major complication of campylobacter infection

Gullian Barre Syndrome

What are three sources of salmonella

Poultry Raw eggs Milk

What is the incubation period of salmonella

12-48h

How does salmonella present

Headache Dysentry Vomiting

What is used to investigate salmonella

Stool MC+S

What is a complication of salmonella

Bacteraemia can lead to osteomyelitis

What are two sources of yersinia

- Pork | - Milk

How can yersinia present

Pseudo-appendicitis

What are two complications of yersinia

Erythema nodosum | Reactive arthritis

How does amoebiasis present

Gradual onset bloody diarrhoea + abdominal pain that can last weeks

What is the most common hospital acquired infection

C.difficle

What is a risk factor for C.difficle infection

Broad-spectrum antibiotics suppress gut flora leading to overgrowth of C.diff

What antibiotics are the main cause of C.difficle infections

Second and third generation cephalosporins

What other antibiotic is associated with causing C.difficle

Clindamycin

What is a risk factor for C.difficle

Antibiotic-use | PPIs

How will C.difficle present clinically

Crampy abdominal pain | Foul-smelling diarrhoea

What test is used to diagnose C.difficle

Two-phase test

Explain the two-phase test

1. ELISA for glutamate dehydrogenase | 2. ELISA for toxin A and toxin B

Why is glutamate dehydrogenase tested for

Presence of GDH indicates clostridium

Why is toxin A and B tested for

If present, indicates infection opposed to colonisation

What is first-line management of C.difficle

Oral vancomycin (14d)

If C.difficle toxic megacolon is suspected what should be done

Contact colorectal surgeons urgently

If unable to take oral food/medication what should be given to treat C.difficle

IV metronidazole

What is the mnemonic to remember infection control with C.difficle

``` S I G H T ```

What is SIGHT

Suspect infection Isolate + contact Infection control Gloves and apron Hand washing Two-phase test

Once lab has confirmed C.difficle what antibiotic should vancomycin be switched to

Oral fidoxamicin (10d)

Which 3 areas is it common to obtain traveller's diarrhoea from

Asia Africa South America

What causes traveller's diarrhoea

Enterotoxigenic E.coli (ETEC)

What are 3 presentations of traveller's diarrhoea

- Watery diarrhoea - Abdominal cramps - Nausea

How can traveller's diarrheoa be prevented

``` Wash hands Peel fruit and veg Boil water Avoid: ice, salads, shellfish Drink through straw ```

How is traveller's diarrhoea managed

Oral rehydration solution. Ciprofloxacin (3d) can be given to individuals if need diarrhoea to stop asap

2: Infections of GI tract Flashcards

(84 cards)