L5: Infectious Diarrhea Flashcards
(98 cards)
1
Q
Def of Diarrhea
A
- Having three or more loose or liquid stools per day, or as having more stools than is normal for that person
2
Q
Mechanisms of Diarrhea
A
3
Q
Defect in Secretory Diarrhea
A
4
Q
Characters of Stool in Secretory Diarrhea
A
5
Q
Examples of Secretory Diarrhea
A
6
Q
Defect in Osmotic Diarrhea
A
7
Q
Characters of stool in Osmotic Diarrhea
A
8
Q
Examples of Osmotic Diarrhea
A
9
Q
Defect in Increased motility Diarrhea
A
10
Q
Characters of Stool in Increased motility Diarrhea
A
11
Q
Examples of Increased motility Diarrhea
A
12
Q
defect in Decreased motility Diarrhea
A
13
Q
Characters of Stool in Decreased motility Diarrhea
A
14
Q
Examples of Decreased motility Diarrhea
A
15
Q
Defect in Decreased surface area Diarrhea
A
16
Q
Characters of stool in Decreased surface area Diarrhea
A
17
Q
Examples of Decreased surface area Diarrhea
A
18
Q
Defect in Inflammatory mucosal invasion Diarrhea
A
19
Q
Stool Characters in Inflammatory mucosal invasion Diarrhea
A
20
Q
Examples of Inflammatory mucosal invasion Diarrhea
A
21
Q
Diagram of causes of diarrhea
A
22
Q
Compare between Non-Inflammatory Diarrhea & Inflammatory Diarrhea
- Symptoms
- Stool
- Site
- Mechanism
- Common Pathogens
A
22
Q
Def of Dysentery
A
23
Q
Causes of Diarrhea
A
Common Viral Causes
- Rotavirus
Common Bacterial Causes
- E-Coli
- Cholera
- Shigella
- Salmonella
- Colstridium
- Staph
Common Protozoal Causes
- Amebiasis
- Giardia
- Cryptosporidium
24
Agde of **Rota Virus**
It causes severe diarrhea among infants and young children
25
MOI by **Rota Virus**
faecal-oral transmission.
26
IP of **Rota Virus**
2 days
27
CP of **Rota Virus**
Disease presented by vomiting, watery diarrhea, low grade feve
28
Hallmark of TTT in **Rota Virus**
maintenance of hydration
29
Prevention of **Rota Virus**
ο Two vaccines are safe and effective in children.
ο Both are taken orally and contain attenuated live virus
30
Most E. coli strains are harmless, but some serotypes are pathogenic and can cause serious food poisoning in humans
..
31
MOI by **E-Coli**
faecal-oral transmission
32
Enterotoxigenic E. coli (ETEC)
Traveler's diarrhea
33
Enteropathogenic E.coli (EPEC)
Rarely causes disease in adults.
34
Enteroinvasive E. coli (EIEC)
Dysentery
35
Enterohemorrhagic E. coli (EHEC)
ο Bloody diarrhea
ο Severe hemorrhagic colitis
ο Hemolytic uremic syndrome in 6-8% of cases
ο Cattle are predominant reservoir of infection.
36
What is the most common illness in travelers?
Traveler's diarrhea
37
Def of **Traveler's diarrhea**
Three or more unformed stools in 24 hours passed by a traveler, commonly accompanied by abdominal cramps, nausea, and bloating
38
Causative agent of Traveler's diarrhea
ο½ Enterotoxigenic E.coli is the most commonly isolated pathogen.
39
TTT of **Traveler's diarrhea**
- Antibiotics are typically given for three to five days, but single doses of azithromycin or levofloxacin have been used.
40
TTT of Traveler's diarrhea if it persists despite antibiotics
If diarrhea persists despite therapy, travelers should be evaluated for possible viral or parasitic infections, bacterial or amoebic dysentery, Giardia, helminths, or cholera
41
IP of **Cholera**
1 - 5 days
42
MOI by **Cholera**
- fecal-oral route, especially contaminated water
43
CP of **Cholera**
- Sudden profuse, painless diarrhea and vomiting of clear fluid.
- "rice water" in nature and may have a fishy odor
44
Investigations in **Cholera**
1) A rapid dip-stick test is available
2) Stool and swab samples collected and cultivated using Enrichment media
45
TTT of **Cholera**
46
Prevention of **Cholera**
47
vaccination of **Cholera**
48
Another Names of **Shigellosis**
Bacillary dysentery or Marlow Syndrome
49
IP of **Shigellosis**
12 - 96 h
50
MOI by **Shigellosis**
- Feco-oral route especially contaminated water
- Less than 100 bacterial cells can be enough to cause an infection
51
Investigations for **Shigellosis**
1) Stool smear revealed red and white blood cells.
2) Culture
52
CP of **Shigellosis**
Range from mild abdominal discomfort to severe dysentery
53
TTT of **Shigellosis**
54
What not to use as TTT in **Shigellosis**?
Antidiarrheal drugs (loperamide) may prolong the infection and should not be used in shigellosis
55
Another Names of **Enteritis Salmonellosis**
food poisoning Salmonell βNon typhoidalβ
56
IP of **Enteritis Salmonellosis**
12 - 72 h
57
MOI by **Enteritis Salmonellosis**
1) Poultry, pork, and beef, if the meat is prepared incorrectly or is infected with the bacteria after preparation.
2) Infected eggs, egg products, and milk.
58
CP of **Enteritis Salmonellosis**
- Nausea, vomiting, abdominal cramps, and bloody diarrhea with mucus.
- Headache, fatigue, and rose spots may present.
- Can be severe, especially in young children and the elderly.
59
Investigations for **Enteritis Salmonellosis**
- Stool smear revealed red and white blood cells.
- Culture (from stool or vomitus) is positive in 10-15%.
60
TTT of **Enteritis Salmonellosis**
- Immunocompromised and patients with evidence of Bacteremia
β Antibiotics, such as norfloxacin, ciprofloxacin or third generation cephalosporin may be given
61
Def of **C. difficile**
- C. difficile is a commensal bacterium of the human
intestine in 2-5% of the population
62
Method of Infection by C. difficile
Antibiotics (clindamycin) (antibiotic associated colitis)
63
CP of C. difficile
- the most common cause of pseudomembranous colitis, and in rare cases this can progress to toxic megacolon, which can be life-threatening
64
Investigations for **C. difficile**
ο Isolation of toxin in stool
ο Culture of organism
65
TTT of **C. difficile**
ο Stop offending agent
ο metronidazole + vancomycin
66
MOT of **Staph-Induced Diarrhea**
ingestion of contaminated food Containing preformed staph (cake, salad, ham) with heat stable
67
CP of **Staph-Induced Diarrhea**
- Nausea, vomiting, abdominal pain followed by diarrhea
- Fever is rare
68
INVx for **Staph-Induced Diarrhea**
- Definite diagnosis is by culturing the organism from
contaminated food, stool or vomitus
69
TTT of ****Staph-Induced Diarrhea****
- Supportive.
- No role for antibiotics bacterial toxins.
70
Common Protozoal Causes of **Diarrhea**
- Amebiasis
- Giardiasis
- Cryptosporidium
71
MOT by **Amebiasis**
Ingestion of cyst (Feco-oral)
72
CP of Amebiasis
1) Asymptomatic
2) Amoebic dysentery.
3) Amoebic liver abscess
**stool samples ELISA or RIA can also be used**
73
TTT of Amebiasis
- Metronidazole for the invasive trophozoites
- A luminal amoebicide for cysts paromomycin or
diloxanide furoate (Furamide).
74
MOT by **Giardiasis**
Ingestion of cyst
75
CP of **Giardiasis**
- Steatorrhea.
- Multiple stool examinations
76
TTT of ****Giardiasis****
- Metronidazole (7 days)
- Tinidazole (single dose)
- Nitazoxanide (3 days)
77
Def of **Cryptosporidium**
an acute, short-term infection, but can become severe and non-resolving in
- Children
- Immuno compromised individuals (HIV)
78
Nature of CP of Cryptosporidium in Children & Immu ocomprimised
can become severe and non-resolving in:
- Children
- Immuno compromised individuals (HIV)
79
CP of Cryptosporidium
- Usually suspected and isolated in HIV patients presenting by diarrhea
80
TTT of **Cryptosporidium**
- Treatment is symptomatic, with fluid rehydration, electrolyte correction
81
Diarrhea is a defense mechanism
...
82
Diarrhea may function as an evolved expulsion defense mechanism
- As a result, if it is stopped, there might be a delay in recovery
...
83
Managment of **Acute Diarrhea**
- Rehydration
- Role of Antibiotics
- Other drugs
84
Managment of **Acute Diarrhea**
- Rehydration
85
The primary treatment of gastroenteritis in both children and adults is .....
Rehydration
86
This is preferably achieved by ......, although intravenous delivery may be required if a there is a decreased level of consciousness or if dehydration is severe.
oral rehydration therapy
87
Managment of **Acute Diarrhea**
- Role of Antibiotics
Antibiotics are not usually used for gastroenteritis, although they are sometimes recommended if:
1) Symptoms are particularly severe
2) If a susceptible bacterial or protozoal cause is isolated or suspected.
3) A macrolide (such as azithromycin) is preferred over a fluoroquinolone in traveler diarrhea due to higher rates of resistance.
88
Bacteria and protozoans that are amenable to treatment include ......
(Shigella, Salmonella typhi and, Giardia. Species)
89
Antibiotics are specific to .....
- Giardia species / Entamoeba histolytica.
β Tinidazole treatment is recommended and superior to metronidazole
90
Antibiotics are useless in .......
Viral gastroenteritis
91
Antibiotics are harmful in cases of .....
- The Pseudomembranous colitis usually caused by antibiotic
- TTT: stop offending agent + metronidazole + vancomycin
92
Other Drugs used in Diarrhea
- Antimotility drugs
- Physical adsorbents
- Role of micronutrients
- Role of probiotics
93
Other Drugs used in Diarrhea
- Antimotility Drugs
Should be avoided.
94
Other Drugs used in Diarrhea
- Physical Adsorbents
Compounds as Bismuth, kaolin, charcoal are postulated to act by adsorbing toxins.
95
Other Drugs used in Diarrhea
- Role of Micronutrients
- Trials of zinc supplementation in India demonstrated clinically important decrease in severity and duration of diarrhea.
96
Other Drugs used in Diarrhea
- Role of Probiotics
- Recommended in diarrhea after use of antibiotics
97
The following types of diarrhea may indicate further investigation
