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Flashcards in diarrhea cases Deck (22)
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1
Q

non inflammatory diarrhea

leftover potato salad

A

S. aureus,

1-6 hr onset, N/V, fever,

2
Q

non inflammatory diarrhea

leftover chinese food

A

Bacillus cereus
pre-formed in rice-reheated
short “emetic” syndrome: 1-6 hrs,

3
Q

non-inflamm. diarrhea

buffet

A

Clostridium perfringens

short incubation: 8-16 hrs, toxin in vivo,

4
Q

Vibrio cholera

A

incub. 16-72 hrs
shellfisch, profuse water diarrhea, rice water
lasts 5-12 days
abx: Fqs tetra, doxy: shorten duration, dec. shedding

5
Q

ETEC

A

72-96 hrs

tropics, traveller’s diarrhea

6
Q

non-inflamm., secretory
cruise ship
nursing homes

A
Norovirus
shellfish, con tam water, aerated vomit
v. contagious
onset 24-48 hrs, last 24-48 hrs
ha, myalgias
7
Q

rotavirus

A

pediatric
winter mos (yr round in tropics)
sev. dehyration, up to 10 days

8
Q

Adenovirus

A

pediatric diarrhea

9
Q

Astrovirus

A

day care kids

10
Q

inflamm.
70 yo, confused
oysters

A
Vibrio parahemolyticus
supportive care, admit for IV fluids
incub. 24 hrs
Japan, gulf coast
undercooked shellfish
explosive
last 3 days
no abx
11
Q

3 yo old boy from day care to Hawaii
bloody diarrhea
spread to fam

A
Shigella
low infectious dose
person-person
milk, ice cream
biphasic: watery, then bloody
"Bacillary dysentery"
1 wk, self-limited
tx to dec. communicability: FQs, TMP-SMX, amp
HUS, reac. arthritis
12
Q

bloody diarrhea 1 day (acute)
fever, prev. doing well
2-3 wks later, leg weakness

A
Campylobacter jejuni
inc. 1-7 days
prodrome, tenesmus, 25% relapse
macrolides, quinolones
undercooked chicken, hikers, travelers
2-3 wks later, leg weakness: Guillain-Barre
also reactive arthritis (6-8 wks)
13
Q

1 wk ago pneumonia
fever 103, diarrhea
elev. WBC (32,000)
hypotnsive, confused, bloody

A

C. diff
older pts
complications: toxic megacolon, pseudomembranous colitis
abx: clinda, FQs-both may cause!
tx w.: vanco, metro, fidaxomycin, fecal microbiota transplant
contact precautions
use PCR to dx

14
Q
3 yo bloody diarrhea
fever 102, watery @ first
fresh apple juice
elev. WBC, low HCT, low platelet
Schistocytes on peripheral sm
elev. CR
A
EHEC: enterohemorrhagec E. coli
june-sept undercooked food, unpast. juice/milk, sprouts, lettuce
incubation 3-4 ds
Shiga-like toxin
tx: TMP-SMX
HUS (75-90% of HUS cases are EHEC)
tx may inc. risk
15
Q
Mexico
fever, chills
frozen margarita
WBC in stools
\+ for blood (but not frank)
A
Salmonella
achlorhydria, SCD pts
eggs, con tam. dairy, poultry
pets: lizards, turtles
tx: does not dec., may inc. risk for relapse, only tx if bacteremic, IC, infants
16
Q

from India, had typhoid fever

acute drop

A

perforation and secondary peritonitis
enteric fever
travellers
goes to lymphatic tissue: Peyer’s patches

17
Q

Yersinia enterocolitica

A

“cold” bug

kids

18
Q

EIEC

A

inflamm and destr intenstinal mucosal

19
Q

loose stools 3 wks

wl, smelly,

A

Giardia
bloating, malabsortion, frothy
waterborne, p-p, hikers, daycares, homosexuals
tx: metro

20
Q

Cryptosporidium parvum

A
low inoculum
HIV: bulky, >30 d
no WBC
reactive arthritis
tx: nitazo, azithro
21
Q

typical for protozoa

A

more chronic, less systemic

22
Q

entamoeba histolytica

A
may be more acute
imported
bloody
fulm. colitis
liver abscess, brain, lung abcess

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