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2010-07-14 #1.3
Microbial pathogens causing diarrhea
| Question | Answer |
|---|---|
| CC of diarrhea in AIDS when CD4 T cell count < 50~100 cells/mm^3: Rx? | ganciclovir (CMV) |
| MCC of "adult" gasroenteritis; common infection on "cruise ships": MOT? | fecal-oral transmission (Norwalk virus) |
| MCC of "childhood" diarrhea in winter months: pathogenesis? type of diarrhea? | damaged ion transport pump in small intestine; secretory diarrhea |
| Rx & ProRx: rotavirus? | rotavirus oral vaccine; oral hydration; nitazoxanide |
| gram[+] rod; reheated fried rice or tacos: Dx? | preformed toxin of bacillus cereus |
| curved[S] shaped gram[-] rod; cattle, chicken, puppies(for children); fecal-oral transmission; MC food-borne illness & invasive entercolitis in US: type of diarrhea? | invasive & secretory enterocolitis: dysentery + crypt abscesses & ulcers resembling ulcerative coliti (Campylobacter jejuni) |
| Rx: Campylobacter jejuni | azithromycin |
| associated with Guillain-Barre syndrome; hemolytic uremic syndrome; HLA-B27 ankylosing spondylitis: Dx? | Campylobacter jejuni |
| preformed toxin: block release of acetylcholine release in presynpatic terminal of neuromuscular junction in ANS; descending paralysis, mydriasis, dry mouth: Dx? | Clostridium botulinum |
| spores: floppy baby with constipation: Rx? | trivalent antitoxin (Clostridium botulinum) |
| MCC of nosocomial diarrhea: Ax? type of diarrhea? toxin? | pseudomembranous colitis; secretory type (Clostridium difficile); exotoxin A & B |
| antibiotic causing C.difficile overgrowth? | ampicillin; quinolones; clindamycin (Clostridium.Q&A) |
| Rx: Clostridium difficile | metronidazole; vancomycin |
| undercooked beef; hemolytic uremic syndrome: Rx? | STEC(O157:H7 serotype); antibiotics X recommended; may enhance toxin release |
| diarrhea with malabsorption in AIDS when CD4 count < 50 cell/mm^3: complication? | foamy macrophages in lamina propria > "Whipple's disease" (Mycobacterium avium-intracellulare complex) |
| acid fast organisms? | MAC; Mycobacterium tuberculosis |
| invasion into Peyer's patches; circumferential spread in lymphatics lead to complication: Dx? | M.tuberculosis; acid-fast |
| 2nd MC food-borne illness in US; raw or undercooked "egg" products, raw milk, milk products, poultry or contaminated water: reservoir? | animal reservoir: turtles, hamsters, lizards |
| Rx: Salmonella enteritidis enterocolitis | ciprofloxacin or levofloxacin |
| invasion into Peyer's patches; sepsis: best diagnostic? | blood culture at week 1 in typhoid fever by S.typhi |
| triad of bradycardia; neutropenia; splenomegaly and diarrhea: Rx? | if symptomatic: luoroquinolone (S.typhi = typhoid fever) |
| no animal reservoir; highly infectious in day care centers; mucosal ulceration + pseudomembranous inflammation in rectosignoid, dysentery: Ax? | seronegative spondyloarthropathy (Shigella sonnei) |
| Rx: Shigella sonnei | if symptomatic: fluoroquinolone or azithromycin |
| azithromycin | Shigella sonnei; Campylobacter jejuni |
| preformed toxin-mediated food poisoning; gastroenteritis in 1 to 6 hrs after eating; diagnostic? | culture "food", X "stool" |
| enterotoxin stimulating adenylate cyclae in small bowel; contaminated water or seafood (esp, crustacea): morphology? Rx? | gram[-] comma-shaped rod; fluid replacement; glucose & sodium in oral supplement (cotransport system for absorption); doxycycline or fluroquinolone |
| fluoroquinolone | Salmonella; Shigella; Vibrio cholerae |
| gram[-] coccobacillus with bipolar staining; granulomatous microabscesses; mimicks acute appendicitis: Dx? | Yersinia enterocolitis |
| association with HLA-B27 positive seronegative spondyloarthropathy & seropositive spondyloarthropathy | Shigella sonnei & Yersinina enterocolitica; Campylobacter jejuni |
| TMP-SMX | Y.enterocolitica; Cyclospora; Isospora |
| transmitted by ingestion of "cysts" in food or water | Balantidium coli; Cryptosporidium parvum(oocysts); Entamoeba histiolytica; Giardia lamblia |
| largest "ciliated" protozoa; colonic ulcer with bloody diarrhea: Dx? | Balantidium coli |
| MCC of diarrhea in AIDs; partial acid-fast; outbreaks of diarrhea in water supply (Milwaukee, Wisconsin): Dx? | Cryptosporidium parvum |
| Rx: Cryptosporidium parvum | nitazoxanide |
| fecal-oral transmission; common in AIDs diarrhea; partially acid-fast oocysts; raspberries | Cyclospora |
| fecal-oral transmission; common in AIDs diarrhea; non partially acid-fast: Rx? | Microsporidia; albendazole |
| nonmotile cysts formed in stool; dysentery; flask-shaped ulcers; "anchovy paste" abscess; RBCs in trophozoites: Dx? Rx? | Entamoeba histiolytica; metronidazole |
| Nitazoxanide | Giardia lamblia; Cryptosporidium parvum |
| MCC protozoal cause of diarrhae in US; day care centers, hikers, water supplies, homosexual, IgA deficiency, CVID; acute and chronic diarrhea with malabsorption: Dx? | Giardia lamblia |
| Rx: Giardia lamblia | tinidazole or nitazoxanide |
| ingestion of eggs in helminths | Enterobius vermicularis; Trichuris trichiura; Ascaris lumricoides |
| diarrhea with B12 deficiency; ingestion of larvae (fish) in lake trout (Great Lakes): Dx? Rx? | Diphyllobothrium latum; praziquantel |
| bare feet; larval phase through lungs; autoinfection; massive reinfection in IC patients; abdominal pain & diarrhea: Dx? | Strongyloides stercoralis |
| Rx: Strongyloides stercoralis | ivermectin |
| blood loss; iron deficiency; intestinal nematode: term? Rx? | Necator americanus; albendazole or mebendazole |
| raw fish dishes (sushi, sashimi); pickled herring; cramping abdominal pain with epigastric distress; IgE antibody test: Dx? | Anisakis simplex |
| MC helminth in US; pruritus ani; urethritis in girls; acute appendicitis; X eosinophilia: Dx? | non invasive Enterobius vermicularis |
| rectal prolapse in children; eosinophilia | Trichuris trichiura (Whipworm) |
| eosinophilia | Trichuris trichiura; larval phase of Ascaris lumbricoides |
| albendazole and/or mebendazole | E.vermicularis; T.trichiura; N.americanus; A.lumbricoides for both |
Created by:
mataos
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