Gastrointestinal infections

GASTROINTESTINAL INFECTIONS

In medical terminology " gastrointestinal " refers to the stomach. A gastrointestinal infection that is affecting the stomach or intestines and usually lead to diarrhea. Some infections, such as E. coli and shingles is caused by bacteria. Others, such as Norwalk and Sapporo, are caused by viruses. Giardia is a gastrointestinal infection caused by parasites. Many of these infections are very contagious. An abdominal infection can spread if a person with traces of bacteria on their hands to touch another person or food from another person. Salmonella is a bacterial infection that is transmitted in this way. It is often found in eggs and chicken. If these products are not properly handled or undercooked, people can become sick. 

 

Gastrointestinal infections associated with eating undercooked contaminated meat, usually that goats, sheep and cows. The infection in the intestines usually caused by an overgrowth of certain bacteria or yeasts. gastro-intestinal infection usually causes germs diarrhea.Which are responsible for diarrhea depends on the geographical infected person, their level of sanitation, economic development, and hygiene. Gastrointestinal infections are common in bacteria, Salmonella, Shigella, E. coli, and parasites such as Giardia and Cryptosporidium. The most common symptoms are: abdominal cramps followed by diarrhea, fever, loss of appetite, nausea, vomiting, weight loss, dehydration, mucus or blood in the stool.

Shingella is a gastrointestinal infection caused by bacteria. Shingella usually transmitted through consumption of infected material, such as water. The bacteria can cause dysentery, which is a disease in which the intestine is inflated. Mucus lining the intestinal wall usually start to decompose and can become apparent in the gut. A person may also develop bleeding ulcers as a result of this infection.

 

The viruses that cause diarrheal diseases, also known as viral gastroenteritis, can pass through a house (or college dorm or anywhere else where many people live together) quickly because they are highly infectious. Luckily, the diarrhea usually goes away by itself within a few days. For teens and healthy adults, viral gastroenteritis is a common problem, but minor. But young children and people with chronic diseases, can lead to dehydration that requires medical attention. Many types of bacteria and parasites can also cause gastrointestinal infections and diarrhea. Most are not serious and disappear after a few days, but others may be very serious.

The incubation period for a gastrointestinal infection can vary depending on the particular germ at the origin. For example, the Shigella incubation period is usually 2-4 days but the period for viral infections ranges from 4-48 hours. Parasitic generally have longer incubation periods, such as Giardia, where the symptoms can take from one to four weeks appears. Then, as the germ and the general health of the person, a diarrheal illness lasting several days or weeks.

Diarrheal infections are very contagious. They can spread from person to person by dirty hands, contaminated food or water and some animals. Most cases are contagious for as long as someone has diarrhea, but some infections can be contagious for longer.

The most effective way to prevent contagious diarrheal infections is to wash your hands frequently. Dirty hands carry germs into your body when you do things like biting your nails or use your hands when you eat. It is important to always wash hands with soap and water after using the toilet and before eating, especially if you know there's a disease going around. Make sure bathroom surfaces are clean can also help prevent infection.

 

 Make sure kitchen counters and cooking utensils are clean, too, especially after they have been in contact with raw meat, eggs and poultry. Avoid eating foods that have been neglected for a few hours, even if it has been reheated, because toxins can survive in food.

If you're traveling or camping, never drink the streams, springs or lakes where the local health authorities have certified the clean water to drink. In some developing countries, you can stick to bottled water and drinks rather than tap water - and watch street vendors to buy food. Pets, especially reptiles, can spread bacteria if not kept separate from the family of European food sectors. Do not clean pet cages or bowls in the sink itself, and the family to prepare meals. And always wash your hands after handling your pet .

 

Most infections, infections that cause diarrhea infections, especially viral, will disappear without treatment. Relax at home and drink plenty of fluids to avoid dehydration are the best ways to overcome the disease. If you become dehydrated, you may need to go to hospital for intravenous (IV) fluids to replace those lost to diarrhea, vomiting and fever. Most infections caused by gastrointestinal viruses and many bacterial infections without treatment, but someone with a weakened immune system that receives a bacterial disease of the bowel may need to be prescribed antibiotics to prevent infection spread throughout the body.

What is peritonitis ?

INTRAABDOMINAL INFECTIONS 

PRIMARY ( SPONTANEOUS ) BACTERIAL PERITONITIS ( PBP ) 

Spontaneous bacterial peritonitis (SBP) is to develop peritonitis (infection of the abdominal cavity), although there is no obvious source of infection.It occurs almost exclusively in cases of portal hypertension of people (more of Increased portal vein pressure ), usually a result of cirrhosis of the liver and liver.It may also occur in nephrotic syndrome patients.

Primary bacterial peritonitis  is seen as the result of a combination of factors associated with cirrhosis and ascites, and prolonged bacteremia secondary to compromised host defenses, maneuvers intrahepatic blood colonized, and the defective bactericidal activity in the ascites fluid. Contrary to previous theories, transmucosal migration of bacteria in the intestine of ascites is no longer considered to play an important role in the etiology of SBP. With regard to the compromised host defenses, patients with chronic liver disease often have severe acute deficiency of the complement and possibly a system malfunction of neutrophils and the reticuloendothelial system.

ETIOLOGIES 

Traditionally, three-quarters of infections were spontaneous bacterial peritonitis caused by gram-negative aerobic organisms (50% of Escherichia coli to be), with one quarter of these infections are caused by aerobic Gram-positive (streptococci 19% .) E. coli is shown in the picture below. However, some data suggest that the percentage of Gram positive infections can aumento.2, 3 One study cited an incidence of 34.2% of streptococci, ranking second after oral streptococci Enterobacteriaceae.3 represented 73.8% of these strains streptococcus. anaerobic organisms are rare due to high oxygen tension of ascites. A body was found in 92% of cases, and 8% of cases are polymicrobial.

SIGN AND SYMPTOMS 

Some Symptoms of fever, chills, nausea, vomiting, abdominal pain and malaise. Patients have complain of abdominal pain and worsening ascites. No sign and symptoms in thirteen percent of patients.Hepatic   encephalopathy  could be the only manifestation of Spontaneous Bacterial Peritonitis in the absence of a trigger for precise encephalopathy, all patients should undergo paracentesis or elimination of ascites fluid to assess the Spontaneous Bacterial Peritonitis.

MORTALITY / MORBIDITY 

The rate of spontaneous bacterial peritonitis mortality ranges from 40-70% in adult patients with cirrhosis and is lower in children with nephrosis. Patients with concomitant renal failure has been demonstrated at a higher risk of mortality of spontaneous bacterial peritonitis than those without concomitant renal insufficiency. due to spontaneous bacterial peritonitis can lower mortality among all subgroups of patients because of advances in diagnosis and treatment.

DIAGNOSIS 

The diagnosis of  Primary Spontaneous Bacterial Peritonitis need paracentesis (fluid aspiration with a needle) from  the cavity of abdomen .  If the fluid contains bacteria or a big amount  of neutrophils (white blood cells), the infection is known, and antibiotics are necessary to avoid complications. In addition to antibiotics, and administered a infusions of albumin.

TREATMENT 

Empirical therapy must be directed against likely causative organisms, such as cocci.Ceftriaxone Gram-negative and Gram-positive or piperacillin / tazobactam is appropriate treatment regimen should be empirically reduced after the etiology is expected to continue for 5-14 days identified.Treatment depending on how quickly the patient's condition improves.

PREVENTION 

Up to 70% of patients relapse within a year.Fluoroquinolones PBP or trimethoprim - sulfametaoxazole. provides an effective method of contraception. However, serious staphylococcal infections resistant to antibiotics or grow over time. 

SECONDARY PERITONITIS 

Secondary peritonitis has several major causes. Bacteria can reach the peritoneum through a hole (perforation) and the digestive tract, which may be caused by a rupture appendix, stomach ulcer or perforated colon. Condition can occur when pancreatic enzymes leak into the peritoneum during pancreatitis or biliary bile loss due to injury, because these chemicals can cause irritation of the peritoneum. Foreign contaminants can also cause secondary peritonitis if they have the abdominal cavity. This can happen if the use of peritoneal dialysis catheters. Inflammation of the abdominal cavity causing bacteria can cause inflammation of the blood (sepsis) and severe disease. Secondary peritonitis can also affect premature babies who have necrotizing enterocolitis.

CLINICAL FEATURES 

Initial symptoms may be localized or vague and depends on the primary organ involved. Once infection has spread to the abdomen, the pain increases, patients LIE still, knees bent often avoid stretching nerve fibers of the abdominal cavity. coughing or sneezing cause serious sharp pain .Voluntary and involuntary marked guarding of anterior abdominal musculature , with often rebound tenderness and fever .

DIAGNOSIS AND TREATMENT 

Studies marked leukocytosis with a left  shift to find the source of peritonitis are the main treatment.  Abdominal taps should be done in cases of abdominal injury to exclude hemoperitoneum. Antibiotic selection for aerobic gram-negative bacilli and anaerobes , for example combinations of penicillin beta-lactamase inhibitors, or in critical condition in intensive care patients, imipenem, or mixed use, such as ampicillin and metronidazole plus ciprofloxacin.Surgical action is often necessary.

PERITONITIS IN PATIENT'S UNDERGOING CHRONIC AMBULATORY PERITONEAL DIALYSIS 

Common causative agents include coagulase negative staphylococci about 30% of cases. Staphylococcus aureus, Gram negative bacilli and fungi such as Candida spp.Several hundered mm dialysis fluid should be centrifuged and sent for culture, blood culture bottles perfectly to improve diagnostic treatment should be directed against the species yield.Empirical  therapy should be given for staphylocaccal and gram negative. If the resistance to methicillin is common, vancomycin may be given and should be allowed to remain in the peritoneal cavity for 6 hours. the critically ill patient should have the same regimen IV.Catheter  removal scheme should be considered if the patient does not improve within 48 hours ....... read more

Peritonitis

Micro-organism enter the sterile abdominal cavity and cause peritonitis if this infection goes untreated patient survives abscesses

INTRAABDOMINAL INFECTIONS 

The intraperitoneal infection, usually due to normal anatomic barrier is broken. This disorder can occur when the appendix, diverticulum, wound or ulcer ruptures, when the intestinal wall is impaired ischemia, tumor or infection (for example, in inflammatory bowel disease ), or adjacent to inflammatory processes, such as pancreatitis or inflammatory pelvic disease in which the enzyme (in the previous case), or bodies (in this case) can leak into the abdominal cavity.


Regardless incitement case, when the inflammation develops and bodies are often contained within the intestines or other body normally sterile peritoneal space, a predictable series of events takes place. intra-abdominal infections occur in two stages: peritonitis and if the patient survives this stage, and Treat an abscess formation. types of micro-organism every phase of infection are responsible for the pathogenesis of the disease.

Most intra-abdominal infections arise from a source in the gastrointestinal tract. They are usually caused by enteric aerobic and anaerobic. The management usually involves an invasive procedure to control the source of infection and antimicrobial therapy against pathogenic microorganisms. In a small number of highly selected patients, these infections can be treated without due process of final source code control.


Antimicrobial therapy is tailored to each patient, with narrow spectrum agents used to treat community infections intra-abdominal and wider spectrum of agents used for nosocomial infections. In general, these infections are associated with significant morbidity and mortality, especially among high-risk patients have impaired host defenses.

PERITONITIS 

Peritonitis Inflammation of the peritoneum, a thin line membrane covering the abdomen and internal organs. The inflammation caused by bacterial or fungal infections in this film. There are two different types of peritonitis. Primary peritonitis due to the spread of infection from blood and lymph to the peritoneum. This type of peritonitis rare - less than 1% of all peritonitis is a priority. The most common type of peritonitis-called secondary peritonitis, caused by infection of the peritoneum should be in the stomach or biliary tract. In both cases of peritonitis are very serious and can be fatal if not treated quickly....... read more

Primary ( Spontaneous )  bacterial peritonitis
Secondary peritonitis

Peritonitis in patients undergoing chronic ambulatory peritoneal dialysis