Infective gastroenteritis - other causes Flashcards
1
Q
What three other biological factors can cause infective gastroenteritis?
A
- Viral - common cause of D+V in young children; rarely seen in adults unless an outbreak in hospital; norovirus is the most common
- Bacterial - most common cause of significant adult gastroenteritis; can cause watery diarrhoea or dysentery (severe and mixed with blood and mucous)
- Parasitic – protozoa; most commonly giardia lamblia
2
Q
What biological mechanisms lead to infective gastroenteritis?
A
- Mucosal Adherence – most bacteria must adhere to specific receptors in the gut mucosa e.g. pili, fimbriae, may be the prelde to invasion or toxin production though EPEC causes diarrhoea just by binding
- Mucosal Invasion – penetration of intestinal mucosa e.g. shigella, EIEC, campylobacter, entrty helped by ‘invasins’ which disrupt the cell’s cytoskeleton, destruction of cells causes the symptoms of dysentery: low volume bloody diarrhoea and abdominal pain
- Toxin Production – enterotoxins: bacteria bind to intestinal epithelium, induce excessive fluid secretion into bowel lumen causing watery diarrhoea w/o damage to cell (so no blood) e.g. cholera, ETEC, cytotoxins: damage intestinal mucosa and vascular endothelium sometimes too
3
Q
Name some types of bacterial/viral infection causes.
A
Salmonella
Campylobacter (jejuni)
Shigella
ETEC
EHEC
Bacillus cereus
Staph A
C diff
4
Q
What is the management plan for infective gastroenteritis?
A
· 1ST LINE: adequate hydration
- ADJUNCT: antimotolity agents such as loperamide à other than those with bloody diarrhoea or fever
· Antibiotic therapy is not usually given as the illness is self-limiting:
- Only given in immunocompromised, pregnant women and those with symptoms lasting over a week
- May increase the risk of HUS (haemolytic uraemic syndrome)
5
Q
What complications can arise from infective gastroenteritis?
A
· Dehydration
· IBS
· Haemolytic uraemic syndrome – rare; usually affects young children and elderl
