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Diarrhoea

The different pathogens causing diarrhoea, source and treatment

Bacteria Source/ historyInv/toxigenicClinical feature Investigations/Treatment Systemic/ special consideratio
Ecoli 0157:H7 Hamburger: Undercooked beef Invasive bacteria: fever, blood in stools, faecal leukocyte in stool No antibiotic Supportive, if needed Plasmapheresis Haemolytic uraemic syndrome, thrombocytopaenia, renal failure
C. difficile Prolonged use of antibiotics Invasive bacteria: fever, blood in stools, faecal leukocyte in stool 1)Metronidazole 2)Oral Vancomycin (not IV vanc. as low conc.) 3) IV metranidazole Psuedomembranous collitis. C.diff toxin in stool
Yersinia Enterocolitica Food and water Invasive bacteria. Abdo pain in right lower quadrant mimicing appendicitis Stool culture and Elisa Ceftriaxone+Gentamycin or Fluroquinolone
Amebiasis Hx of travel Fever abdominal pain, bloody diarrhoea Elisa for amoeaba antigen using serum or stool - for acute. Metranidazole + Paromycin or Inodoquinol Mucosal thickening and classic flask shaped ulcer. May mimic UC. Complication: Hepatic Abscess
Staph aureus Diary products and meat Toxigenic: watery diarrhoea, no blood, no fever, no faecal luecocyte. Vomiting more prominent than diarrhoea Supportive Rapid onset within <8 h.
Bacillus Cereus Reheated rice Toxigenic Vomiting more prominent than diarrhoea Supportive
Clostritium Perfringens Rewarmed meat TOxigenic Diarrhoea more prominent than vomiting Supportive
Enterotoxigenic Ecoli Hx of travel DIarrhoea more prominent than vomiting Ciprofloxacin
Vibrio Parahaemolyticus Sea food Toxigenic Diarrhoea more prominent than vomiting Supportive
Vibrio cholera Contaminated water Toxigenic Diarrhoea more prominent IV fluids + Tetracycline
Viral gasteroenteritis Most common FEVER, VOmiting but no leucocyte present in stool, NO blood.
Campylobacter Jejuni Eating undercooked poultry Invasive bacteria: fever, blood in stools, faecal leukocyte in stool Ciprofloxacin or Erythromycin Reactive arthritis, Gulliane Barre syndrome
Shigella Not washing hands and cleaning food products Invasive bacteria: fever, blood in stools, faecal leukocyte in stool Ciprofloxacin Haemolytic Uraemic syndrome, Reactive arthritis
Salmonella Poor kitchen hygiene, not cleaning food, poorly thawed food. Invasive bacteria Do not give antibiotics as it prolongs the carrier state. Indications of antibiotics: Bacteraemia or immunicompromised patient, hx of aortic aneurysm. Ciprofloxaccin * faecal leukocyt not present in salmonella*
Created by: Vernificus
 

 



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