Bacteria
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Bacteria
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Diarrhoea
The different pathogens causing diarrhoea, source and treatment
Bacteria | Source/ history | Inv/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* |