The different pathogens causing diarrhoea, source and treatment
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| 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
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| 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
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| Yersinia Enterocolitica | Food and water | Invasive bacteria. Abdo pain in right lower quadrant mimicing appendicitis | Stool culture and Elisa Ceftriaxone+Gentamycin or Fluroquinolone |
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| 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
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| 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.
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| Bacillus Cereus | Reheated rice | Toxigenic Vomiting more prominent than diarrhoea | Supportive |
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| Clostritium Perfringens | Rewarmed meat | TOxigenic Diarrhoea more prominent than vomiting | Supportive |
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| Enterotoxigenic Ecoli | Hx of travel | DIarrhoea more prominent than vomiting | Ciprofloxacin |
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| Vibrio Parahaemolyticus | Sea food | Toxigenic Diarrhoea more prominent than vomiting | Supportive |
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| Vibrio cholera | Contaminated water | Toxigenic Diarrhoea more prominent | IV fluids + Tetracycline |
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| Viral gasteroenteritis | Most common | FEVER, VOmiting but no leucocyte present in stool, NO blood. |
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| Campylobacter Jejuni | Eating undercooked poultry | Invasive bacteria: fever, blood in stools, faecal leukocyte in stool | Ciprofloxacin or Erythromycin | Reactive arthritis, Gulliane Barre syndrome
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| Shigella | Not washing hands and cleaning food products | Invasive bacteria: fever, blood in stools, faecal leukocyte in stool | Ciprofloxacin | Haemolytic Uraemic syndrome, Reactive arthritis
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| 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*
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