Bugs and Drugs GI
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Help!
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| Clostridium dificile type of bacteria | anaerobic
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| How does C. diff spread | spores-need to wash hands with soap and water
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| Symptoms C. diff | diarrhea, no blood, crampy pain esp with BM
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| Complication C. diff | toxic megacolon- peristalsis stops and dilates, leads to colectomy because of necrosis
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| Risk factors for C. diff | -abx use, hospitalization
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| Diagnosis of C diff | 2 step testing: ag in stiool, then PCR for toxin (not all C diff make toxins)
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| Treatment C diff | Well: Flagyl 500 PO TID X14 d. Sick: Vanco 125 PO QID X14d, consult gen surg
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| Relapse tx of C. diff? | First: Flagyl. 2nd: Vanco. 3rd: HELP!
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| Peds and C. diff? | Commonly colonized, but unlikely to be causing diarrhea. Don't test for.
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| When to do stool O&P? | Bloody, travel history, longer than 1 week, fever (also consider blood culture)
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| Typhoid fever organism and mode of infection | Salmonella typhi, GN rod, fecal-oral (incl water)
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| Symptoms of typhoid fever | Starts with low grade fever, liver enzymes rise, GI tract weeks later, diarrhea/constipation
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| Complications tyhoid fever | Perforation, GIB, osteomyelitis, septic arthritis
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| Diagnosis typhoid fever | Blood culture, stool culture (3rd week on), bone marrow (CALL ID)
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| Treatment typhoid | Call ID! Ceftriaxone
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| Risk factors for thrush | AIDS (normal in babies), inhaled steroids, immunocompromised
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| Liver abscess causes | *diverticulitis, appendicitis or biliary tree obstruction
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| Bugs in liver abscess | anaerobes, GN
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| Treatment of liver abscess | Drain!! Pip-tazo OR ceftriaxone + metronidazole
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| Entamoeba histolytica organism type | amoeba!! protozoan
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| Risk factors for Entamoeba | Travel history, Mexico, tropical, fecal-oral transmission
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