Download Chapter 8 – Gastrointestinal Tract Infections

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Bacterial Food Poisoning
Bacterial Enteritis and Enteric Fevers
Bacterial infection of the stomach,
esophagus and intestines
Gastrointestinal disease caused by other
pathogens
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By ingestion of food contaminated with
preformed toxins
Also might contain metals, pesticides and
other toxic substance
The symptoms more rapid compared to
infections
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S.aureus – food handler
Soil organisms such as water, feces, sewage
(nature food contamination)
Others: Campylobacter jejune,
Staphylococcus aureus, Clostridium
perfringens, C.botulinum and Bacillus cereus
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Feces – physical determination, isolation
and component analysis
Food – contaminated
Gastric juice / fluid
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Basically in uncooked or inadequate cooked
food. And unrefrigerated.such as??
Releasing endotoxin A or D
Bacteria producing toxin instead of multiply
Causing symptoms – abdominal pain,
diarrhea, nausea n vomiting
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Clostridium perfringens – undercooked meats
and gravies, late onset and lasting, only during
sporulation, gas gangrene and anaerobic
cellulitis
Clostridium botulinum – minor in GI but major
in nervous system
Bacillus cereus – contaminated rice / meat
dishes, vomiting, short time onset and period
of infection
Pseudomonas cocovenenans – bongkrek disease
(coconut) – cause fatal
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Enteritis – an inflammation of intestine; not
intoxication
Invade and damage the intestinal mucosa or
deeper tissue
Small intestine – diarrhea
Large intestine – dysentery (severe
including mucus, blood and pus)
Leading to enteric fever such as typhoid
fever
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By genus Salmonella – typhi, choleraesuis
and enteritidis
Detection using serotype identification –
molecular/special test
Other than typhi can cause typhoid fever
Normal flora of poultry, wild birds and
rodents
The particular animal infected seriously /
just carrier – 90% pet reptiles carrier
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Normal flora of poultry, wild birds and
rodents
The particular animal infected seriously /
just carrier – 90% pet reptiles carrier
Infected hen to the laying eggs
Trace from contaminated food and water
In daily life – improper preparation of food
(uncooked egg and meat/dairy product)
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Abdominal pain, fever and diarrhea with
blood and mucus
Onset 8 – 48 hours after ingestion
Fever – endotoxin release during lysis
Self-limiting lasts 1 – 4 days
No need of antibiotic
Infant and elderly more severe
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S.typhimurium and S. paratyphi cause more
serious condition – enterocolitis
Incubation period up to 10 days
Cause fever and chills for 1 – 3 weeks
No antibiotic suitable – increase spectrum
of normal flora of GIT
Maintain the sanitary water and food
supplies
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Primarily – caused by S.typhi
In faulty and sewage system- uncooked
shellfish, raw fruit and raw vegetable
Bacteremia and septicemia
Patient having headache, malaise and fever due
to toxication
Invade mucosa and excrete thru stool
Infect lymphoid tissue such as Peyer’s patches
(rose spots)
Antibiotic – fluoroquinolones, chloramphenicol
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Bacillary dysentery – serovar A
(dysenteriae), B (flexneri), C (boydii) and D
(sonnei)
In day-care-centre, 10 organisms enough to
cause infection
Contaminated food, finger, flies, feces and
fomites
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Vibrio vulnificus and V. Parahemolyticus
In poor country
Mild and not true cholera
If caused by Vibrio cholerae – rice water
stool – chronic cholera
Test of microscopic observation until
serological test - IgA
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Largely caused by V. parahemolyticus
Contaminated fish and shellfish
Endotoxin released
12 hr after entering body
Last fo 2 -5 days
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Caused by E.coli O157:H7
Others are Campylobacter, rotavirus,
Giardia, Entamoeba, Salmonella
Strain that is enterotoxigenic (ETEC) or
enteroinvasive (EIEC), enterohemorrhagic
(EHEC) (also cause hemorrhagic uremic
syndrome-HUS)
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Caused by Campylobacter pylori
Is a cofactor for stomach cancer
Penetration so called as perforation
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Drinking too much alcohol
Regular use of aspirin, ibuprofen, naproxen,
or other nonsteroidal anti-inflammatory
drugs (NSAIDs). Taking aspirin or NSAIDs
once in awhile is safe for most people.
Smoking cigarettes or chewing tobacco
Being very ill, such as being on a breathing
machine
Radiation treatments
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Feeling of fullness -- unable to drink as
much fluid
Hunger and an empty feeling in the
stomach, often 1 - 3 hours after a meal
Mild nausea (vomiting may relieve
symptom)
Pain or discomfort in the upper abdomen
Upper abdominal pain that wakes you up at
night
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Esophagogastroduodenoscopy (EGD) is a
special test performed by a gastroenterologist
in which a thin tube with a camera on the end
is inserted through your mouth into the GI tract
to see your stomach and small intestine. During
an EGD, the doctor may take a biopsy from the
wall of your stomach to test for H. pylori.
Upper GI is a series of x-rays taken after you
drink a thick substance called barium.
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Aslo known as rotavirus
Infecting infants and children
Causing watery diarrhea within 2 days
3rd virus causing fatality in children
Contain dsRNA and observe using EM
Diagnosis of stool using ELISA
Also caused by species of Enterovirus,
Clostridium difficile and can inflammed nervous
system
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In the United States, rotavirus infection
outbreaks are common during the winter
and spring months. It is particularly a
problem in childcare centers and children's
hospitals because rotavirus infection is very
contagious.
Usually this happens when kids don't wash
their hands often enough, especially before
eating and after using the toilet.
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have fever, nausea, andvomiting, often
followed by abdominal cramps and
frequent, watery diarrhea.
Kids may also have a cough and runny nose.
Some rotavirus infections cause few or no
symptoms, especially in adults.
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An inflammation of liver, caused by viruses
Can also caused by amoeba and toxic chemical
substance
Hep A – infectious hepatitis (fecal-oral route)
Hep B – serum hep (blood)
Hep C – NANB hep (parenterally – blood) –
liver transplant
Hep D – delta hep (blood)along wt HBV
Hep E – NANBNC hep (enterically – fecal oral)
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Giardiasis
Amoebic Dysentery and chronic amebiasis
Balantidiasis
Cryptosporidiosos
Cyclosporiasis
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Penicillin and Aspergilus
Strongyloidiasis
Tapeworms
Fluke
Trichinosis
Hookworm
Ascariasis
Trichuriasis
Pinworm