Internal medicine notes

Apr 16th, 2015
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GASTROENTERITISProf T RogersDept of Clinical MicrobiologyGASTROENTERITISAcute gastro-intestinal illness usually due toinfectionCharacterised by vomiting and diarrhoeaCan occur at all ages, but infants principal groupMore common in countries with poor hygienestandards, water sanitation problemsSporadic or epidemic formsOften associated with food poisoningCauses of acute diarrhoea ininfancy and childhoodNon-enteric causes: otitis media.Meningitis, sepsis generallyNon-infectious causes: milk/food allergies,drug side effects, malabsorptionInfections of the gastrointestinal tractInfantile gastroenteritis: principalcausesEscherichia coli-enteropathogenic-enterotoxigenic-enteroinvasiveViruses-rotavirus-Noroviruses (Norwalk like)Enteropathogenic Esch coli (EPEC)Small intestine affectedLocal destruction of intestinal epithelialcellsCauses infantile diarrhoeaFever, nausea, vomiting, non-bloodystoolsSelf-limitingSupportive care, no specific antibiotictreatmentEPEC ContdMore than 20 (O) serotypes have beenidentified in outbreaks of infantilediarrhoeaMay affect maternity or neonatal unitsAdherence and colonizing factors appearimportant in pathogenesis (no toxin)Enterotoxigenic Esch coliInfant diarrhoea, Travelers diarrhoeaCause low grade fever, nausea, waterydiarrhoea, crampsSmall bowel affectedHeat labile enterotoxin with cholera likeeffect Heat

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