Gastrointestinal Tract Infections
Content
Bacterial Food Poisoning Bacterial Enteritis and Enteric Fevers Bacterial infection of the stomach,
esophagus and intestines Gastrointestinal disease caused by other
pathogens
BACTERIAL FOOD POISONING
Food poisoning
By ingestion of food contaminated with preformed toxins
Also might contain metals, pesticides and other toxic substance
The symptoms more rapid compared to infections
Bacterial entering food
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
Samples
Feces – physical determination, isolation and component analysis
Food – contaminated Gastric juice / fluid
Staphylococcus Enterotoxicosis
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
Other causes
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
BACTERIAL ENTERITIS AND ENTERIC FEVERS
Introduction
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
Salmonellosis
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
Source of infection
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)
Pathogenesis
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
Other species
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
Typhoid fever
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
SA
LMO
NELLA
TYPH
I
Shigellosis
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
Asiatic cholera
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
Vibriosis
Largely caused by V. parahemolyticus Contaminated fish and shellfish Endotoxin released 12 hr after entering body Last fo 2 -5 days
Traveler’s diarrhea
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)
BACTERIAL INFECTION OF THE STOMACH, ESOPHAGUS AND INTESTINES
Peptic ulcer and Chronic Gastritis
Caused by Campylobacter pylori Is a cofactor for stomach cancer Penetration so called as perforation
PEPTIC
ULC
ER
Causes
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
Symptoms
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
Diagnosis
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.
VIRAL GASTROINTESTINAL DISEASES
Viral Entritis
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
Contagious
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.
RO
TAV
IRU
S
Symptoms
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.
Hepatitis
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)
Hep A
Hep A
Hep B
Protozoan
Giardiasis Amoebic Dysentery and chronic amebiasis Balantidiasis Cryptosporidiosos Cyclosporiasis
Fungal toxin
Penicillin and Aspergilus
HELMINTHS
StrongyloidiasisTapewormsFlukeTrichinosisHookwormAscariasisTrichuriasisPinworm
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