Food poisoning - Cholera - v.cholerae - rota virus infections

Babies in day care have an increased risk of infection by rotavirus ,giardia lamblia and compylobactor

INFECTIOUS  NON - INFLAMMATORY DIARRHEAS 

BACTERIAL FOOD POISONING 

 

Evidence of a common source outbreaks occur frequently. First Staphylococcus aureus enterotoxin produced in food left at room temperature (eg a picnic). The incubation period is 1-6 hours. Disease products within 12 hours, and consist of diarrhea, vomiting and stomach cramps usually without fever. Second Bacillus cereus . (A). emetic form : this is a food poisoning associated with S. aureus contaminated fried rice. (B). Diarrhea as: incubation period of 8-16 hours, diarrhea, cramping, no vomiting. 3rd Clostridium perfringens : spores resistant to heat sufficient in meat, poultry and legumes, incubation 8-14 hours, 24 hours of diarrhea and cramping abdominal disease, without vomiting or fever.

 

CHOLERA 

 

Etiology 

Vibrio cholerae serogroups OI (EI biotypes classical and Tor and O139 ).

 

 

Epidemiology 

Occur in the delta of the Ganges in the Indian subcontinent and South east Asia and sometimes in coastal areas of Texas and Louisiana: the spread of faecal contamination of water and food sources. Infection requires a large consumption of inoculation. toxin to cause disease symptoms. clinical symptoms.

 

Clinical Manifestations 

Incubation period of 24-48 hours following a painless diarrhea and vomiting, which can cause serious and rapid dehydration and death within hours. Rice water turbid liquid stool gray with patches of mucus.

 

Diagnosis .. stool  culture on selective medium  (e.g. TCBS agar). 

 

 

TREATMENT 

Rapid replacement of fluid, electrolytes and base with high sodium levels to correct the loss of Na in the stool or Ringer's lactate in patients with> 10% weight loss.Antibiotics can be used together, doxycycline, ciprofloxacin single dose of 1 g / d or erythromycin three divided doses for 3 days.

 

 

VIBRIO PARAHAEMOLTICUS AND NON - OI ,CHOLERA 

 

These infections are associated with the consumption or contaminated by sea water, badly seafood.After an incubation period of four hours to four days, darrhea aqueous, abdominal cramps, nausea, vomiting and sometimes fever and chills develop.The disease lasts 3-7 days and requires supportive care. Patients with comorbid illness (eg liver disease), sometimes extra-intestinal infections requiring antibiotics 

 

 

NORWALK VIRUS AND RELATED HUMAN CALCIVIRUSES 

 

 

These viruses are common causes of traveler's diarrhea and viral gastroenteritis in patients of all ages and epidemics worldwide, with U.S. higher prevalence in colder climates. Shellfish concentrate the virus by filtration and are at particular risk. Very small Inocults required for infection. Thus, although the fecal-oral route is the main form of transmisson, aerosol, fomites of contact, and person to person contact can cause an infection.

 

Clinical Manifestations 

After incubation period of 24 hours (range 12-72 hours). The patients experience sudden onset of nausea, vomiting, diarrhea or abdominal cramps with constitutional symptoms. the stool is soft, watery, without blood or mucus leukocytes. disease lasts 12 60 hours.

 

Treatment 

Only the necessary support measures. 

 

 

ROTA VIRUS 

 

Rotavirus is the leading cause of severe diarrhea in infants and young children, and is one of several viruses that cause infections, often called stomach flu, but not from the flu. It is a kind of double-stranded RNA virus in the family Reoviridae. At the age of five years, nearly all children worldwide have been infected with rotavirus at least once. But each infection, immunity develops, subsequent infections are less serious, and adults are rarely affected. There are five species of this virus, called A, B, C, D and E. A rotavirus, the most common causes of more than 90% of infections in humans.

Rotavirus is transmitted by fecal-oral contact with contaminated hands, surfaces and objects, and possibly by the respiratory route. The faeces of an infected person can contain more than 10 billion of infectious particles per gram, only 10-100 of them are required to transmit the infection to another person.

 

Clinical Manifestations 

Rotavirus gastroenteritis is a mild to severe illness characterized by vomiting, watery diarrhea and mild fever. When a child is infected with the virus has an incubation period of about two days before the onset of symptoms. Symptoms often start with vomiting, followed by four to eight days of severe diarrhea. Dehydration is more common than rotavirus infection in most of those caused by pathogenic bacteria, and is the most common cause of deaths related to rotavirus infection.

 

Diagnosis 

Enzymes immunoassays (EIAs ) or viral RNA detection  ,like PCR can identify this virus in sample of stool . 

 

Treatments 

Only necessary treatment is required .Antimotility agents should be avoided .

 

Prevention 

For prevention ,vaccine was withdrawn shortly after approval by the U.S . Drug and Food intake because it was causally linked to intussusception .

 

Diarrhea causes

Diarrhea in the 14 days called persistent diarrhea

INFECTIOUS  NON - INFLAMMATORY DIARRHEAS 

Diarrhea is a deviation from normal intestinal movements are characterized by increased stool frequency or liquidity, or both, often accompanied by an abnormal increase in stool weight per day (200 grams / day). It is classified as acute if the onset occurred within 14 days. Diarrhea in the 14 days called persistent, and beyond 30 days, is considered chronic. Diarrhea can be  recurrent diarrhea, infectious and noninfectious diarrhea, inflammatory diarrhea, which causes inflammation of the colon and diarrhea that are not lit noninflamatory colon.

There are different clinical settings where patients are more at risk than the general population of developing diarrhea. Babies in day care have an increased risk of infection by rotavirus, Giardia lamblia, and Campylobacter. Although HIV / AIDS patients may have atypical infections are most often infected with pathogens such as Escherichia coli usual. Cryptosporidiosis, Isospora belli, herpes simplex, Chlamydia trachomatis, Clostridium difficile, Shigella and other types of infection causes diarrhea in AIDS patients. Travelers are at risk from the bacterium E. enterotoxigenic E. coli, Rotavirus, Salmonella and Shigella.

Inflammatory diarrhea is suspected when patients present with acute diarrhea accompanied by bloody stools, fever, tenesmus, or abdominal pain. If the inflammation is in the colon, the stool is frequent and small in volume, whereas diarrhea due to small bowel inflammation is usually high in volume. In either case, stool leukocytosis is present, with more leukocytes the more distal the inflammation, as a rule. Infectious causes of inflammatory diarrhea include Salmonella, Shigella, Campylobacter, enterohemorrhagic E. coli, enteroinvasive E. coli, C. difficile, Entamoeba histolytica, and Yersinia. When inflammatory diarrhea is recurrent, noninfectious etiology should be suspected, such as Crohn's disease, ulcerative colitis, and radiation or ischemic colitis.

inflammatory diarrhea characterized by watery stools that may exceed 1 liter in volume, without symptoms suggestive of inflammation. It is caused by bacteria such as Vibrio cholerae, E coli and Staphylococcus food poisoning and Clostridium, viruses such as rotavirus and Norwalk virus and protozoa such as Cryptosporidium and Giardia. enterotoxins Many of these organizations and the development of interfering with the mechanism of absorption or secretion of diarrhea in the intestine, causing.

TRAVELER'S DIARRHEA 

People traveling in Asia, Africa and South and Central America 20 to 50% experience sudden onset of stomach cramps, loss of appetite and diarrhea. The disease usually begins within 3-5 days of arrival, containated associated with eating food or water, it takes 1-5 days, mostly due to enterotoxigenic Escherichia coli, subsalicylates bismuth can be used preventively. Liquefaction is usually adequate treatment, but if desired, 1-3 days during the fluoroquinolones can reduce the duration of illness is 24-36 hours. Antimotility agents can control diarrhea.

Endocarditis treatment

It rapidly damages cardiac sites seeds extra-cardiac sites hematogenously and can progress to death within weeks ,incidence increases in elderly 

The incidence of infective endocarditis in the general population is estimated  approximately at 2 and 6 cases of 100 000 person-years, but significantly higher in patients with underlying valvular heart disease and the abuse of intravenous drugs. In addition, invasive procedures are performed also technically strong health care system can cause infections of the bloodstream and cause blood poisoning. Although historically rheumatic  valvulitis has often been regarded as a predisposing factor in endocarditis, times have changed. mitral valve prolapse, bicuspid aortic disease and aortic valvular heart disease are now the most frequent causes. Furthermore, the prosthetic valve heart defects in about one third of all cases of endocarditis, and affects 1% to 3% of patients after cardiac valvular surgery.

SIGN AND SYMPTOMS

In many cases the infection develops very slowly. Sometimes called subacute bacterial endocarditisor SBE. Symptoms can develop gradually, over weeks or months and may be vague. You tend to feel generally unwell and may have general aches and pains, fatigue, and may be out of food. The fever (high temperature) develops at some point in most cases. In these early symptoms may be caused by many other conditions, the cause of the symptoms can not be diagnosed for a while. Murmurs tend to develop heart. These are sounds that can be heard by a doctor listens to your heart with a stethoscope. murmurs are caused by an abnormal flow of blood through faulty valves or damaged. If you already have a murmur heart of an existing valve problem, the murmur may change or become more intense. A new murmur or change is often what alerts a physician to suspect infective endocarditis.

In some cases, the symptoms pretty quickly and it can be very bad for several days. Speed at which the disease develops depends in part on which bacteria or fungi that cause infection. Some bacteria are more virulent than others.



DIAGNOSIS

Infective endocarditis diagnosis based on symptoms, results of medical examinations and results of diagnostic tests:

Blood cultures show bacteria or microorganisms commonly found in endocarditis. blood cultures, blood tests can be time consuming for the laboratory to isolate specific bacteria causing the infection. Must be taken before antibiotics are started, if you have blood poisoning.

Echocardiogram (heart ultrasound) may show growths, abscesses (holes), the new regurgitation (leakage) or stenosis (narrowing), or an artificial heart valve that has begun to move away from the heart tissue. Occasionally, doctors insert an ultrasound probe in your esophagus or esophageal (TEE) to obtain a very detailed look at heart.

Other signs and symptoms of infective endocarditis included :

Emboli (small clots), bleeding (internal bleeding).
Stroke .
Shortness of breath .
Night sweats.
Loss of appetite or weight loss .
Muscle and joint pain


TREATMENT

When bacteria cause infective endocarditis , identified by blood culture tests ,Doc should start immediately intravenous (IV) antibiotic therapy. Intravenous antibiotics may be administered up to six weeks to control the infection. The symptoms will be monitored during treatment and blood tests to determine the effectiveness of treatment. If damage  of cardiac valves occurs, surgery may be needed to establish the heart valve and improve cardiac function.Treatment of infective endocarditis  starts with prevention. When endocarditis occurs, prompt treatment is necessary to prevent damage to heart valves and for more serious complications, including death...... read more

Rheumatic fever symptoms - Leptospirosis -Listeria symptoms

SYSTEMIC / MULTISYSTEM INFECTIONS 

RHEUMATIC FEVER 

Rheumatic fever is an inflammatory disease that can develop after an infection with Streptococcus bacteria (such as strep throat and scarlet fever) and can involve the heart (especially the valves), joints, skin and brain. Rare in developed countries like Great Britain, USA and Australia. Incidence has dropped by 10% of children in 1920 to 0.01% of all children today. This reduction in the incidence reflect advances in infection control and treatment of streptococcal infections to antimicrobials. The disease is still prevalent in developing countries such as the Middle and Far East and Latin America.

Rheumatic fever is preceded by a throat infection with Streptococcus organsisms. After infection with group A streptococcal pharyngeal, usually in childhood (5-15And) is followed by a systemic syndrome I think it is caused by an autoimmune reaction triggered by an infection. Syndrome includes: 1) Arthritis (multiple join pain and swelling) 2), carditis (heart inflammation) 3) The cutaneous manifestations 4) manifestations5 nervous system), fever, joint pain 50% etc.About Patients who develop carditis during the initial phase of the disease will continue to develop long-term heart disease and rheumatic valvular disease.

1) Blood tests: ESF and CRP (non-specific inflammation), leukocytosis2) Studies in X-ray may be a sign of heart infection, pericarditis, pericardial effusion effusion.3) ECG may signs of inflammation of the heart (extended range PR) or, and pericarditis (saddle-shaped ST elevation). Parts of the acute clinical syndrome may recur after the first period. However, projected common disease, skin disease and nerve disease associated with rheumatic fever is excellent with no known long-term consequences. rheumatic heart disease has traditionally been hailed as an important causal factor of cardiac valvular disease and makes the associated morbidity and mortality.

LEPTOSPIROSIS 

Leptospirosis is a rare infection, serious and contagious caused by bacteria of several species of the genus Leptospira, a micro-organism spiral (spirochete). Leptospirosis is often called the swineherd's disease, swamp fever, or mud fever. The organism enters the body when mucous membranes or abraded skin comes into contact with contaminated environmental sources. The infection causes a systemic disease that can often lead to renal and hepatic failure as possible. 

 Leptospirosis is a zoonosis (animal care) infection with a worldwide distribution and incidence. The incidence varies from sporadic in temperate zones endemic in some tropical countries. The disease has a seasonal incidence. Most cases occur during the rainy season in the tropics and in western countries in late summer or early fall, when soil is moist and alkaline. Leptospirosis is usually associated with tropical countries and heavy rains, but most cases occur in temperate climates, probably due to underreporting in some countries.

In general, the prognosis associated with this disease is good, usually with full recovery after infection. more serious systemic infections (Weil's disease), can lead to renal (kidney) or hepatic (liver), myocarditis (heart inflammation), and can be potentially fatal.

Approximately 15-40% of patients are exposed, but do not become ill show serologic (blood or urine or saliva) evidence of a past existing infection. This statistic includes 15% of abattoir workers, home workers, and the incubation period is usually between 7-12 days veterinarians.The, with a range of 2-20 days. About 90% of patients experience a mild form of the disease,
and about 5-10% have the severe form with jaundice, also known as Weil's disease. The natural course of leptospirosis is divided into two very distinct phases, sepsis and immune systems. For a brief period of 1-3 days between the first and second phase, the patient shows some improvement.

LISTERIOSIS 

Listeriosis is an infectious disease caused by foodborne bacteria Listeria monocytogenes. The symptoms are the symptoms of upper respiratory tract and septiceamia. Listeriosis is of particular concern during pregnancy because it can cause miscarriage, stillbirth, premature delivery and sepsis (full body infection) and pneumonia in newborns.

It is an environmental organization that is ubiquitous in soil and rotting matter.It affect both animals and humans, the most common way of infection to humans in contaminated food. The organism can grow at temerature as low as 4 degrees Celsius, and the foods most frequently implicated are soft cheeses, unpasteurized, raw vegetables and the chicken heads. Listeriosis is a rare but serious infection that mostly affects infants, pregnant women, elderly and immunocompromised, L. monocytogenes has also been recently recognized as a cause of self-limiting gastroenteritis, foodborne healthy adults, but the incidence of this phenomenon is unknown....... read more

Systemic infection

SYSTEMIC / MULTISYSTEM INFECTIONS 

 

SEPTICAEMIA 

 

Sepsis is a serious condition characterized by inflammation in the body. It is caused by bacteria entering the bloodstream, which triggers an immune response, causing inflammation and a closing body systems slow to treat the infection. This disease can be fatal, especially if the patient is allowed to make progress in the shock phase and departure can be alarmingly quickly. If sepsis is suspected, a patient transported to hospital for immediate medical care.

SEPTICAEMIA 

 

The causes of sepsis are varied. Typically, the patient is vulnerable due to age or condition, and bacteria simply enjoy the situation. Surgery latent infections, and burns can all cause blood poisoning, which is a very good reason to keep any infections to ensure they do not spread. A case of sepsis begins with bacteria that produce toxins in the bloodstream, causing blood clotting, the body tries to fight against bacteria.

 

MENINGOCOCCAL SEPTICAEMIA 

 

Meningococcal septicemia (blood poisoning) - This is the most dangerous and deadly of the two diseases. It occurs when bacteria enter the bloodstream and multiply uncontrollably, damaging the walls of blood vessels and cause bleeding under the skin. The disease is called sepsis and meningitis is usually associated with the eruption of purple. Sepsis can cause death within hours, or permanent disabilities such as scars and amputations. See the animation below shows how it travels through the blood system. 

MENINGOCOCCAL SEPTICAEMIA 

 

The disease is carried in asmptomatically 50-20% of the population. It is found worldwide in the five major serogroups. Meningococcal group A causes epidemic disease in sub-Saharan Africa and parts of Asia. Groups Y and W also cause an infection outbreak. B and C tend to cause sporadic infections in Europe and North America. The disease occurs only in a small percentage of those colonized. It depends on both host and bacterial factors and are more likely following viral upper respiratory tract. Man is the only known reservoir of disease. Meningococcal disease occurs when bacteria invade the nasal mucosa and into the bloodstream.

 

TULAREMIA 

 

Tularemia, also known as "rabbit fever", is a disease caused by the bacterium Francisella tularensis. Tularemia is typically found in animals, especially rodents, rabbits and hares. Tularemia is a disease usually in rural areas and has been reported in all states of the United States except Hawaii. Typically, people infected by the bites of infected insects (most commonly, ticks and horseflies) by handling infected sick or dead animals, eating or drinking contaminated food or water by respiration bacteria from the air.

Tularemia

 

Its  a common  widespread disease in animals. About 200 human cases of tularemia are reported each year in the United States. In most cases occur in parts of south-central and western states. Almost all cases occur in rural areas, and those resulting from bites of ticks and biting flies or handling infected rodents, rabbits or hares. Cases the result of breathing the bacteria into the air and laboratory accidents. people develop symptoms depends on how they are exposed to tularemia. Possible symptoms include skin sores, swollen lymph nodes, painful, inflamed eyes, sore throat, mouth sores, diarrhea or pneumonia. If bacteria are inhaled, symptoms may include sudden onset of fever, chills, headache, muscle aches, joint pain, dry cough and progressive weakness. People with pneumonia can develop chest pain, difficulty breathing, spitting blood and respiratory failure. Rabbit fever can be fatal if the person has not been treated with appropriate antibiotics.

 

Francisella tularensis is highly contagious. A small number of bacteria (10-50 organisms) can cause disease. If Francisella tularensis were used as a bioweapon, the bacteria were probably made in the air to be inhaled. People who inhale the bacteria can experience severe respiratory diseases like pneumonia and systemic infection serious if not treated.

 

The incubation period (time to be exposed to fall ill) for tularemia is usually 3-5 days, but can vary from 1-14 days. If you think you have been exposed to tularemia bacteria, consult a doctor quickly. Treatment with antibiotics for a period of 10-14 days or more after exposure may be recommended. If you have any antibiotics, it is important to take following the instructions you receive. All medications you take, be taken.

 

 

Cyclosporiasis - Microsporidia

INFECTIOUS NON - INFLAMMATORY DIARRHEAS 

CYCLOSPORIASIS 

A parasitic disease caused by Cyclospora cayetensis transmitted through food or water contaminated by infected feces. Some cases are asymptomatic, while others can be very severe and untreated cases can suffer relapses.

cyclosporiasis reasons are contaminated water or produce, or exposure to the organism during travel to countries where it is endemic. Immunosuppression is a risk factor for chronic cyclosporiasis in endemic areas or very popular in these areas.

Cyclospora cayetanensis oocysts when you enter the small bowel mucosa and penetrates it incubates for about a week. After incubation, the person begins to experience severe diarrhea, edema, fever, abdominal pain and muscle aches. Oocysts may be present due to contaminated water or human feces as fertilizer. This infection primarily affects humans and other primates.

DIAGNOSIS AND TREATMENT 

The diagnosis can be difficult due to the lack of recognizable oocysts in the feces. The use of evidence such as DNA PCR and acid-fast stain can help in identification. The infection is often treated with CPT, as conventional anti-protozoa are not sufficient. To prevent transmission through food, cooking and trying to prevent water while outdoors. 

MICROSPORIDIOSIS 

Microsporidiosis is a disease caused by infection by microscopic organisms called microsporidia. Microsporidia are eukaryotic parasites that must live in host cells in which others can produce infectious spores. These spores cause microsporidiosis, a disease that is mostly seen in people infected with human immunodeficiency virus (HIV). Microspridiosis is an opportunistic infection that causes diarrhea and intestinal wasting in immunocompromised individuals (HIV, for example). It follows from the different species of microsporidia, a group of parasitic protozoa.

DIAGNOSIS 

There are several tests available for diagnosing microsporidian infection. Microscopic examination of stained specimens of body fluids, especially fecal samples, allowing a rapid diagnosis, although the exact nature of microsporidia can not be identified. Urine samples can also be used to detect spores when the kidneys and / or participation of the bladder. 

TREATMENT 

Treatment of microsporidiosis is usually made in therapy and supportive treatment. Depending on the species infected with microsporidia and different drugs are used. The drugs most commonly used for microsporidiosis are albendazole (Albenza) and fumagillin. Patients with diarrhea, management of intravenous fluids and electrolytes may be necessary to satiety. Diet, nutrition and farm management can help with chronic diarrhea. Moreover, to improve the immune system with antiretroviral therapy in patients with HIV infection can also lead to an improvement of symptoms.

Health information - Isosporiasis

NFECTIOUS NON - INFLAMMATORY DIARRHEAS

ISOSPORIASIS

Isosporiasis is a disease caused by protozoan Isospora Belli. Organism to infect the lining of the small intestine and can cause severe diarrhea and malabsorption (inability to absorb nutrients). Isospora beautiful spread in the faeces. Food or water contaminated by animal droppings can do this organism, it is also possible that oral-anal sex can spread the infection. Sometimes it occurs can be traced isosporiasis water contaminated by faeces. Isosporiasis is not common in the United States is more common in tropical areas of the world and in places where water contamination is a problem. isosporiasis United States is the first AIDS-defining illness in approximately 0.2% of AIDS.

CLINICAL MANIFESTATIONS

The infection causes severe diarrhea, not the blood and abdominal cramps that can last for weeks and the result of malabsorption and weight loss. In immunocompromised patients and in infants and children, diarrhea can be severe. Eosinophilia may be present (otherwise other protozoal infections).

DIAGNOSIS

Large oocyst detection in stool by modified acid-fast staining .


TREATMENT

Isosporiasis effective treatment is a combination of two drugs: trimethoprim and sulfamethoxazole (TMP-SMX, Bactrim, Septra). Treatment isosporiasis two double-strength tablets of TMP-SMX twice daily. The alternative is the double strength tablet three times daily. TMP-SMX therapy usually continues for 2-4 weeks. Patients who are intolerant to SMX, drug pyrimethamine (Daraprim), together with folinic acid can be implemented. This combination of drugs used per month.

To help control diarrhea, perhaps in combination with antibiotic treatment, a number of anti-diarrhea medication may be taken. And because the diarrhea is the direct result of intestinal inflammation caused by infection, certain drugs non-steroidal anti-inflammatory drugs (NSAIDs) help, such as ibuprofen. Another drug, has proven to significantly reduce diarrhea due to its anti-inflammatory drug, thalidomide (Thalomid). Women taking this drug should avoid becoming pregnant Thalidomide can cause severe birth defects.

PREVENTION

The most effective way to prevent isosporiasis is to eliminate its sources, mainly foods potentially contaminated human feces. This is particularly true for HIV positive people with weakened immune systems rave tion in the tropics and subtropics where water and food may be contaminated. Drink bottled water and ensure that food is cooked properly, can help reduce the risk of any rave isosporiasis tion in the tropics and subtropics.