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Diarrhoea

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Created by: Vernificus

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*