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Flashcards in diarrhea cases Deck (22):
1

non inflammatory diarrhea
leftover potato salad

S. aureus,
1-6 hr onset, N/V, fever,

2

non inflammatory diarrhea
leftover chinese food

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

3

non-inflamm. diarrhea
buffet

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

4

Vibrio cholera

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

5

ETEC

72-96 hrs
tropics, traveller's diarrhea

6

non-inflamm., secretory
cruise ship
nursing homes

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

7

rotavirus

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

8

Adenovirus

pediatric diarrhea

9

Astrovirus

day care kids

10

inflamm.
70 yo, confused
oysters

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

11

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

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

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

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

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

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

3 yo bloody diarrhea
fever 102, watery @ first
fresh apple juice
elev. WBC, low HCT, low platelet
Schistocytes on peripheral sm
elev. CR

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

Mexico
fever, chills
frozen margarita
WBC in stools
+ for blood (but not frank)

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

from India, had typhoid fever
acute drop

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

17

Yersinia enterocolitica

"cold" bug
kids

18

EIEC

inflamm and destr intenstinal mucosal

19

loose stools 3 wks
wl, smelly,

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

20

Cryptosporidium parvum

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

21

typical for protozoa

more chronic, less systemic

22

entamoeba histolytica

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

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