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.

Chemotherapy protocols

Anti microbial ( antibiotics ) chemotherapy have had a major impact on life threatening infections 

ANTIMICROBIAL CHEMOTHERAPY PROTOCOLS

One of the greatest triumphs of modern medicine has been the introduction of a rational system of antimicrobial chemotherapy to fight against infectious diseases. Since time immemorial, people have used use mussels or mussel extracts to treat infections. In the early days of microbiology, an attempt was made to use extracts of fungal cultures to prevent infections of surgical wounds.

PRINCIPLES OF USE

Antibiotics are among the safest  of medicines, especially for  community infections, and a significant impact on life-threatening infections and reduce morbidity associated with many common infectious disease.This in turn is partly responsible for the overprescribing of these drugs, which led to concern about the increasing resistance to antibiotics.

Most antibiotic prescribing, particularly in the community, is empirical. While in hospital practice, microbiological documentation of the nature of infection and the sensitivity of the pathogen is not usually available for a day or two. the initial choice of treatment depends on clinical diagnosis and in turn a provisional microbiological diagnosis. This treatment "blind therapy targeting the pathogen most likely responsible for a specific syndrome, such as meningitis, urinary tract infection or pneumonia. Initial critically ill patients are often broad to cover the range of possible pathogens, but should be reduced when the microbiological data available.

BACTERICIDAL VERSUS BACTERIOSTATIC

In most infections there is no conclusive evidence that bactericidal drugs (penicillins, cepholosporins, aminoglycosides) are more effective than bacteriostatic drugs, but it is generally considered necessary to resort to the former i treat bacterial endocarditis in patients with mechanisms host defense are involved, particularly those with neutropenia. drug combinations are often necessary for reasons other providin spectrum covers - large. Initially Tuberculosis  is treated with three or four agents to avoid resistance to inhibition emerging.Synergistic is obtained through the use of penicillin and gentamicin in enterococcal endocarditis or gentamicin and ceftazidime in life - threatening Pseudomonas infection.

PHARMACOKINETIC FACTORS

To be successful enough to receive an antibiotic to penetrate the site of infection. Knowledge of standard pharmacokinetic aspects of absorption, distribution, metabolism and excretion of drugs have varied. difficult areas are the brain, eye and prostate cancer, but loculated abscesses are inaccssible most authors. Many of mild to moderate infections can be treated is compatible. Parenteral administration is reported seriously ill patients to ensure a rapid blood and tissue concentrations of antibiotics drug.Some only be administered parenterally, such as aminoglycosides and broad-spectrum cephalosporins. parenteral therapy is needed even to those who are unable to swallow or if gastrointestinal absorption is unreliable.

ANTIBIOTIC CHEMOPROPHYLAXIS

These are some indications the use of condoms antibiotics.These understand the conditions where the risk of infection is high (colon surgery), or the consequences of a severe infection (endocarditis, sepsis, post-splenectomy). The selection is determined by representatives of the likely risk of infectious disease and confirmed the efficacy and safety of treatment..... read more

Chemotherapy regimens

ANTIMICROBIAL CHEMOTHERAPY REGIMENS

DOSE AND DURATION OF THERAPY

This varies depending on the nature, severity, and response to therapy. The long-term treatment (up to 6 weeks) is required for some varieties of infective endocarditis when pulmnary tuberculosis were treated for at least 6 months. Treat many common infections, improvement occurs within 2-3 days, when the patient is afebrile or leukocytosis have been resolved, the mouth should be considered in these parenteral therapy.Five started seven days of therapy is sufficient for most infections. A short course of therapy (3 days or less) should these symptoms of uncomplicated bacteria (cystitis), minimizing the duration of treatment reduces the risk of side effects and super-infection of Candida spp or Clostridium difficile, as well as the cost of care. Breasts that concentrates in the cell, such as erythromycin, quinolones and tetracyclines are used in the treatment of mycoplasma, brucellosis, and Legionella infections.

RENAL AND HEPATIC INSUFFICIENCY

Many drugs require dose reduction of renal failure to prevent toxic buildup. This is particularly true beta lactums and aminoglycosides. Nalidixic acid and tetracycline, other doxycyclines, should be avoided. This hepatic impairment, caution and the dose should be reduced by agents such as isoniazid, ketoconazole, rifampin, and interferon.

THERAPEUTIC DRUG MONITORING

In order to ensure more non-toxic concentrations of therapeutic drugs, drugs such as aminoglycosides and vancomycin serum monitored, especially those with impared renal or change function.Peak (after 1 hour - the dose) and through the (pre-dose) on serum samples be tested. However, the increasing use of once daily doses of aminoglycosides, but the time randm serum analysis are being adopted.

MECHANISMS OF ACTION AND RESISTANCE TO ANTIMICROBIAL AGENTS 

Antibiotic works in different places for bacteria. Penecillin, cephalosporins and vancomycin, erythromycin cell wall and protein synthesis aminoglycosides, rifampicin effect on RNA synthesis and effect of metronidazole, quinolones and DNA synthesis. Sulfonamides and trimethoprim are folic acid antagonists and amphotericin B to prevent the synthesis of fungal sterols. Antibiotic resistance may be due to:

•  Failure to reach the target site, for example, because the causes of deterioration of permeability does not reach the outer membrane of    bacteria (eg, penicillin and Gram-negative).
•  Enzyme inactivation (eg, enzymes beta-lactamase).
•  Change the target site (eg, a point mutation in E. coli penicillin binding protien Strep.pneumoniae lead to resistance.

The development or acquisition of resistance to an antibiotic that the bacteria always involves either a mutation in a single point in a gene or transfer of genetic material from another organism. large fragments of DNA can be introduced into bacteria either by transfer of " naked " DNA or by a bacteriophage (a virus) DNA vector.Both the past (processing), and one (transduction) depend integration of new DNA into the chromosomal DNA recipient. This requires a high degree of homology between donor and recipient of the chromosomal DNA. Finally, resistance to antibiotics can be transferred from one bacterium to another by conjugation, where DNA extrachromosomal (plasmid) that contains resistance factor (R factor) is transferred from one cell to another by contact Direct. Transfer of these plasmids R factors can occur between unrelated bacterial strains and involve large amounts of DNA and often code for multiple resistance antbiotic.

The transformation is probably the least clinically relevant mechanism, while the transduction and transfer of R factors are generally responsible for the immediate emergence of antibiotic resistance in bacteria, increasing resistance to many antibiotics has developed...... read more 

What is a respiratory infection ?

This system is much more vulnerable to infections than other body parts

RESPIRATORY TRACT INFECTIONS

Respiratory infections are divided into upper respiratory tract infections and lower, separated by Carina. In health, the lower respiratory tract is normally sterile because of an extremely effective defense system. Upper respiratory tract infections are particularly common in the paranasal sinuses and childhood.The Middle ear structures are consistent and may be involved minor viral infections of lower respiratory nasopharynx.The is often compromised by smoking, pollution air, aspiration of airway secretions and chronic lung diseases, including chronic bronchitis and chronic obstructive pulmonary disease. Respiratory infections is defined clinical, radiological, sometimes, as in cases of pneumonia, and appropriate microbiological sampling.

The respiratory system is much more vulnerable to infection than other body parts. This is because it is easier for bacteria or viruses from entering the channel when someone breathes in. respiratory tract infections are more common during the winter. This is probably due to the winter people are more likely to stay in close contact with each other. Children tend to get more respiratory infections such as colds than adults. Because they have not yet developed immunity to many viruses that cause colds.

Respiratory infections are a common cause of the disease. Respiratory infection is most common cold. The respiratory system is a general term used to describe all parts of the body that are involved in helping a person to breathe. health professionals generally make a distinction between:

UPPER RESPIRATORY TRACT INFECTIONS
LOWER RESPIRATORY TRACT INFECTIONS

PATHOPHYSIOLOGY

The transmission of microorganisms responsible for the URI is produced aerosol droplets or direct contact with the hand in hand with infected secretions, including transport as a result of the nostrils or eyes. 7Thus, transmission occurs most often in crowded conditions. Direct invasion of respiratory epithelium results in symptoms compatible with the area (s) in question. sinusitis and acute bronchitis is often preceded by a cold. sinus allergies, anatomical abnormalities like a deviated septum, sinus ostium blockage caused by swelling of the mucosal immune disorders such as hypogammaglobulinemia and infection with human immunodeficiency virus, the abuse of cocaine and predispose to the development of acute sinusitis.

The majority of influenza epidemics, 20 century were caused by viruses, but few have been caused by influenza B. Most of the epidemics is believed to spread from students to their families. Annual influenza epidemics due to the supply of influenza virus mutants that most people have no immunity (antigenic drift). Pandemics, on the other hand, occur when a completely new influenza virus is transmitted to humans from other species, pigs and birds most common (antigenic shift). Persons aged 65 years and the underlying disease are at higher risk than healthy people to death and hospitalization due to worsening of their underlying disease as a result of influence....... read more

Upper respiratory infections

Children tend to get more respiratory infections such as colds than adults because they have not yet developed immunity to many viruses

UPPER RESPIRATORY TRACT INFECTIONS 

upper respiratory tract infections (URTI or URI), are diseases caused by an acute infection involving the upper respiratory tract: nose, sinuses, pharynx and larynx.

upper respiratory tract infection  is a non-specific term used to describe acute infections of the nose, sinuses, pharynx, larynx, trachea and bronchi. The prototype is the disease known by the name of common colds, which will be discussed here, in addition to pharyngitis, sinusitis, and tracheo-bronchitis. Influenza is a systemic disease involving the airways and should be distinguished from other URI.

  

CAUSES 

Viruses cause most Upper Respiratory tract Infections with rhinovirus, parainfluenza virus, coronavirus, adenovirus, RS virus, Coxsackievirus, and the influence accounted for the majority of cases.  Human Metapneumovirus was recently found to cause material URI. beta-hemolytic streptococcus group (GABHS) causes 5% to 10% of cases, pharyngitis in adults. Other less common causes of bacterial pharyngitis are C beta-hemolytic streptococcus group, Corynebacterium diphtheriae, Neisseria gonorrhoeae, Arcanobacterium haemolyticum, Chlamydia pneumoniae, Mycoplasma pneumoniae, and herpes simplex virus. Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and are the most common organisms that cause bacterial super-infection of virus in acute sinusitis.  Less than 10% of acute tracheobronchitis due to Bordetella pertussis, B. parapertussis, M. or C. pneumoniae pneumoniae.

SIGN AND SYMPTOMS 

Acute upper respiratory tract infections are fever, pharyngitis / tonsillitis is often called the flu, and their complications: sinusitis, otitis, laryngitis, bronchitis, and sometimes (even if the bronchi are generally classified as part of the lower respiratory tract.) Symptoms URI common cough, sore throat, runny nose, nasal congestion, headache, low fever, facial pressure and sneezing. Onset of symptoms usually begin 1-3 days after exposure to pathogenic microorganisms. The illness usually lasts 7-10 days.

Group A beta hemolytic streptococcal pharyngitis / tonsillitis (strep throat) presents with sudden onset of sore throat, painful swallowing and fever. Strep throat usually does not cause a runny nose, changes in voice or cough. pain and ear pressure caused by middle ear infection (otitis media) and redness of the eye caused by a viral conjunctivitis is often associated with upper respiratory infections.

DIAGNOSIS 

Upper respiratory tract infections are diagnosed on the type and duration of symptoms. cold symptoms last for months, but do not cause sinus problems, allergies may actually be related.

TREATMENT 

The preferred treatment of upper respiratory infections is rest and plenty of fluids. Over-the-counter cold, flu and sinus remedies and pain relievers may provide temporary relief from symptoms but does not reduce infection. Gargle with salt water can help relieve the symptoms of sore throat. Steaming bowl of soup can help relieve nasal congestion opening. Antibiotics are not effective in treating viral infections, and only prescribed if the cause is a bacterial symptoms, such as sore throat, tonsillitis, earaches, or sinus infections. The best treatment for laryngitis is to rest his voice. repeated periods of tonsillitis treated surgically remove the infected tonsils. Mild croup can be treated at home with rest, fluids and a humidifier. However, children are hard to beat the basin in the hospital. 

If you have an upper respiratory infection, take plenty of rest and fluids. Call your doctor if symptoms worsen or last more than a week. Keep mucous membranes moist with a humidifier and petroleum jelly around the nose. nosedrops Saline may also help loosen mucus. Your doctor may tell you how this solution and how to use it often. You can help prevent upper respiratory tract, avoiding touching your eyes, nose and mouth, which would spread the virus your hands have contacted.

Bacterial infection of the central nervous system can cause abscesses

INFECTIONS OF THE NERVOUS SYSTEM 

 

The central nervous system or central nervous system includes the brain, spinal cord and membranes. In certain circumstances, bacteria can penetrate the central nervous system areas. If this occurs, abscesses or empyemas may be established. In general, the CNS is well defended against infection. The spine and brain are sheathed in hard, protective membrane. The outer membrane, the dura, and the next layer, the arachnoid, totally covering the brain and spinal cord. However, these defenses are not absolute. In rare cases, bacteria have access to areas of central nervous system.

 

There are four main causes of infections of the central nervous system (CNS): bacteria, viruses, fungi and protozoa.

 

Bacterial infection of the central nervous system can cause abscesses and empyema (accumulation of pus). Abscesses have fixed boundaries, but no definable shape and size empyema. CNS infections are classified according to where they occur. For example, a spinal epidural abscess is located above the dura mater, and subdural empyema occurs between the dura and arachnoid injury. As the pus and other material of an infection accumulate, pressure is exerted on the brain or spinal cord. This pressure can damage the nervous system tissue, perhaps permanently. Without treatment, CNS infection is fatal.

The brain is highly protected, and is essential for the maintenance of life. Yet the central nervous system infections are occurring. They range from a latent is rapidly fatal. This guide describes some of the features of CNS infection and laboratory diagnosis. The membranes surrounding the brain infections called meningitis. When the content of the brain that is infected with meningitis. brain abscesses are defined, localized lesions within the brain. "Slow" brain infections also occur, and these are usually fatal. Rapid diagnosis of CNS infections is important because many of the central nervous system infections are life threatening.

 

Viruses that infect the central nervous system (brain and spinal cord) include herpesviruses, arboviruses, coxsackieviruses, echoviruses and enteroviruses. Some of these infections primarily affect the meninges (the tissues covering the brain and spinal cord) and the result of meningitis. Others affect primarily the brain and cause encephalitis. Infections that affect both the meninges and brain after a meningo-encephalitis. Meningitis is most common in children than is encephalitis.

The virus affects the central nervous system in two ways. They can directly infect and destroy cells of the central nervous system during acute illness. After recovery from an infection of the central nervous system or elsewhere in the body's immune response to infection sometimes causes secondary damage to cells that surrounds nerve. These secondary damage (postinfectious encephalomyelitis or acute disseminated encephalomyelitis) results in children having more symptoms weeks after recovery from acute illness.

 

Meningitis is usually caused by viruses. Viral meningitis is a self-limiting disease. Bacterial meningitis is much less common, but is a potentially fatal condition. Other organizations may be a rare cause meningitis, for example, spirochetes and fungi. Symptoms include fever, severe headache, neck stiffness and photophobia. Due to the severity of the condition, so it may be caused by a number of staff, fast and accurate diagnosis of the cause is essential for prompt initiation of appropriate treatment.

 

Fungal infections of the central nervous system (CNS) are increasingly diagnosed both in immunocompromised and immunocompetent persons. Sinocranial aspergillosis more frequently described from temperate countries, most often in otherwise immunocompetent individuals. The clinical syndromes as fungal infections of the central nervous system can present are protean and may involve most neuroaxis. Certain clinical syndromes are specific to certain fungal infections. The nose shape is the most common syndrome with zygomycosis and skull-base syndromes frequently in clinical syndromes in patients with aspergillosis sino-cranial. Sub-acute and chronic meningitis in patients infected with HIV are more likely to be due to cryptococcal infection. Early recognition of clinical syndromes in an appropriate clinical context, it is the first step towards full recovery in some of these infections. 

 

 

CONGENITAL INFECTIONS OF CENTRAL NERVOUS SYSTEM 

 

Although vaccines, new antimicrobial agents and improvement in hygiene practices, congenital infections remain a major cause of mortality and neurological morbidity in children long term worldwide. important players are Toxoplasma gondii, cytomegalovirus, Treponema pallidum, herpes simplex virus types 1 and 2, and rubella. In addition, several other agents, such as varicella-zoster, parvovirus B19, and Borrelia burgdorferi, which potentially can infect the fetus and result in the fetus. This paper provides an overview of these infectious disorders, and outlines current strategies for the treatment of acute and long-term treatment.

               

Infectious diseases

INFECTION AND INFECTIOUS DISEASE 

INFECTIOUS AGENTS 

The world is full of microorganism ,the vast majority of which are harmless to man and many of which are essential to life .Some of these organism live on or within human hosts: most of these form part of our normal flora and are benign passenger or symbiotes.A minority ,however ,ar pathogenic ,causing illness or even death to their host .It is thses viruses ,bacteria , protozoa ,and worms which are responsible for the infectious disease.

Infection remains the main cause of morbidity and mortality in man ,particularly in underdeveloped areas where it is associated with poverty and overcrowding .In the developed world increasing prosperity ,universal immunization and antibiotics have reduced the prevalence of infectious disease .However ,antibiotic -resistant strains of bacteria as well as viruses and ' new ' diseases such as human immunodeficiency virus ( HIV ) infection and variant Creutzfeldt-jakob disease ( vCJD) have emerged .Increased global mobility has aided the spread of infectious disease and allowed previously localized pathogens to establish themselves world-wide .Deteriorating social conditions in the inner city areas of our major conurbations have facilitated the resurgence of tuberculosis and other infection.Changes in farming and food-processing methods have controlled to an increase in the incidence of food and water-borne disease.

In the developing world successes such as the eradication of smallpox have been balance or outweighed by the new plagues.Infectious cause nearly 25% of all human deaths .Two billion people -one third of the world's population-are infected with tuberculosis ,250-300 million people catch malaria every year ,and 200 million are  infected with schistosomiasis .Infections are often multiple and there is synergy both between different infections ,and between infection and other factors such as malnutrition.Many of the infectious diseases affecting developing countries are preventable or treatable ,but continue to thrive owing to lack of money and political will.

INFECTIOUS AGENTS

The causative agents of infectious diseases can be divided into four groups.

Prions  are the most recently-recognized and the simplest infectious agents ,consisting of a single protein molecule.They contain no nucleic acid and therefore no genetic information : their ability to propagate within a host relies on inducing the conversion of endogenous protein into prion protein.

viruses  contain both protein and nucleic acid and so carry the genetic information for their own reproduction.However ,they lack the apparatus to replicate autonomously ,relying instead on "hijacking " the cellular machinary of the host .They are smalll ( usually less than 200 nanametres in diameter ) and each virus possesses only one species of nucleic acid ( either RNA or DNA ).

Bacteria  are usually though not always ,larger than viruses .Unlike the latter they have both DNA and RNA , with the genome encoded by DNA ,They are enclosed by a cell membrane ,and even bacteria which have adopted an intracellular existence remain enclosed within their own cell wall. Bacteria are capable of fully autonomous reproduction ,and the majority are not  dependent on host cells.

Eukaryotes are the most sophisticated infectious organism ,displaying sub-cellular compartmentalization .Different cellular functions are restricted to specific organelles ,e.g photosynthesis takes place in the choloroplast ,DNA transcription in the nucleus and respiration in the mitochondria ,Eukaryotic pathogens include unicellular protozoa ,fungi ( which can be unicellular or filamentous ) ,and multicellular parasite worms.

Other higher classes ,notably the insects and the arachnids ,also contain species which can parasitize man and cause disease .