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GASTROINTESTINAL TIC BORNE INFECTIONS

GASTROINTESTINAL TIC BORNE INFECTIONS. Martin D. Fried, MD, FAAP Pediatric Gastroenterology Physician Nutrition Specialist 3200 Sunset Ave Suite 100 Ocean, NJ 07712. Gastrointestinal Complaints. Apthous Ulcers. Canker Sore. Erythema Nodosum. Psoriasis. Ulcers. Colitis.

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GASTROINTESTINAL TIC BORNE INFECTIONS

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  1. GASTROINTESTINALTIC BORNE INFECTIONS Martin D. Fried, MD, FAAP Pediatric Gastroenterology Physician Nutrition Specialist 3200 Sunset Ave Suite 100 Ocean, NJ 07712

  2. Gastrointestinal Complaints

  3. Apthous Ulcers

  4. Canker Sore

  5. ErythemaNodosum

  6. Psoriasis

  7. Ulcers

  8. Colitis

  9. Rectal Fissure

  10. Skin Tag vsGranuloma

  11. Psoriasis with Granuloma

  12. SINGLE INFECTIONS 30

  13. COINFECTIONS = 20

  14. TRIPLE INFECTIONS = 6

  15. 80 PATIENTS, 88 INFECTIONS

  16. Heartburn, Abdominal Pain, Skin Rash, Gastritis, and Duodenitis Bartonella henselae

  17. Cat Scratch Fever • Lymphandenopathy • hepatitis-elevated liver enzymes • Splenitis • Pneumonitis • Fever Unknown Origin

  18. Gastrointestinal Bartonella • Hepatosplenic Abscess • Abdominal Pain-burning • Mesenteric Adenitis-mimic Appendix

  19. GI Presentation • Heartburn • Abdominal Pain • Skin Rash-striae –stretch marks • Enlarged Lymph nodes

  20. VIOLACEOUS RASH

  21. NEW BLOOD VESSELS

  22. GI Infections • tic bite • No prior GI complaints • No steroid use • No abrupt weight gain

  23. Infection and or Diet • Pain not resolved by antacids, Histamine blockers, PPI

  24. Violaceous- deep reddish purple Serpinginous- “snake like” Breast or lower back Groin or back knee Periumbilical (belly button) Inner thigh stretch marks are different Skin Rash

  25. Mesenteric Adenitis • CT Abdomen • Lymph Nodes > 1cm in diameter • May mimic appendicitis

  26. Endoscopy and Biopsy • Assess the GI mucosa • H. pylori • Bartonella by PCR • Borelliaburgdorferi PCR • Mycoplasma PCR • Ehrlichia and Babesia PCR

  27. Bartonella Pathology • Chronic Gastritis and or duodenitis • No Ulcer • No evidence of allergy (eos) • No Acute Inflammation (polys)

  28. Bartonella Rashes • Maculopapular • Urticarial • ErythemaNodosum (crohns also) • GranulomaAnnulaire (ringworm) • Thrombocytopenic Purpura • LeukoclasticVasculitis

  29. Striae • Endothelial Proliferation • Differentiate from stretch marks • in obese or steroid using patients

  30. Bartonella GI Inflammation • An Association Shown • IL-2, IL-6, IL-10, Elicited

  31. Interleuken 6 • Multipotent cytokine • Elicited by Infections • Induces inflammation NEOVASCULARIZATION

  32. NEOVASCULARIZATION NEW BLOOD VESSELS

  33. STEROID EFFECT

  34. STEROID EFFECT

  35. SERPINGINOUS RASH = INFECTION

  36. SNAKE LIKE = INFECTION

  37. Bacteria Infects humans only Transmitted - human to human

  38. H. pylori • Irritant to stomach lining • Cause of gastric, duodenal ulcers • Lifelong infection unless treated • Predispose to stomach cancer due to chronic irritation

  39. H pylori breath test

  40. Helicobacter pylori Nodularity Gastritis

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