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Acute Intestinal Infections.

Acute Intestinal Infections. Lecturer: ass.prof. Gorishna I.L. Etiology of Acute Intestinal Diseases. bacterial agents Escherichia coli Shigella, Salmonella, Campylobacter jejuni Yersinia enterocolitica. Clostridium difficile Vibrio cholerae enteroviruses (infectio enteroviralis)

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Acute Intestinal Infections.

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  1. Acute Intestinal Infections. Lecturer: ass.prof. Gorishna I.L.

  2. Etiology of Acute Intestinal Diseases • bacterial agents • Escherichia coli • Shigella, • Salmonella, • Campylobacter jejuni • Yersinia enterocolitica. • Clostridium difficile • Vibrio cholerae • enteroviruses (infectio enteroviralis) • Rotavirus • Coxsackie viruses • ECHO (Enteric Cytopathogenic Human Orphan) viruses • AstrovirusParvovirus - Parasites • Giardia lamblia • Cryptosporidium

  3. Escherichia Coli Infection • is an acute infectious disease mainly of early age children, caused by different pathogenic strains of Escherichia coli(Enterotoxigenic, Enteropathogenic, Enteroinvasive, Enterohemorrhagic, Enteroaggregative)

  4. Etiology • Escherichia coli, a facultatively anaerobic gram-negative bacillus, is a major component of the normal intestinal flora and ubiquitous in the human environment.

  5. Transmission The way of transmission • Contact • Alimentary (by water, milk, • food)

  6. Localisation of the process – in small intestinum

  7. Enterotoxigenic E.coli infection • Acute beginning from the repeated vomiting, watery diarrhea. • Intoxication is absent; body temperature is normal or subfebrile. • grumbling along thin intestine during palpation. • Feces 15-20 time per days, watery without pathological admixtures, of rice-water character. • Development of severe dehydration • Duration of the disease 5-10 days.

  8. Lab Studies: • Routine stool cultures • Rapid enzyme immunoassays for E coli 0157:H7 • Stool test (koprogram): inflammatory changes, intestinal enzymopathy • Electrolyte changes in blood • Full blood count

  9. stool cultures

  10. Shigellosis (dysentery) • An acute human infectious diseases with enteral infection that is characterized by colitic syndrome and symptoms of general intoxication, quite often with development of primary neurotoxicosis.

  11. Etiology of Shigella Infection • Shigella dysenteriae • Shigella sonnei • Shigella flexneri • Shigella boydii

  12. Transmission Shigella is spread through fecal-oral mechanism of transmission. The way of transmission • Contact • Alimentary • Watery

  13. Localisation of the process

  14. Classification of Shigella Infection • Clinical Form • With dominance of toxicosis • with dominance of local inflammation • Severity (mild, moderate and severe) • Course • acute (up to 1.5 mo) • subacute (up to 3 mo) • chronic (about 3 mo) • recurrent • constantly recurring IV. Complicated or uncomplicated V. Bacterium carrying

  15. Toxicosis, marble skin

  16. With dominance of local inflammation • Sudden onset of high-grade fever • abdominal cramping • abdominal pain, • tenesmus, • and large-volume watery diarrhea → • fecal incontinence, and small-volume mucoid diarrhea with frank blood

  17. Sunken abdomen, dehydration

  18. Shigella Infection false urge to defecate

  19. Stools with greenish and mucous

  20. Rectal spit

  21. Rectal prolapse

  22. Lab Studies: • The white blood cell count is often within reference range, with a high percentage of bands. Occasionally, leukopenia or leukemoid reactions may be detected. • If HUS, anemia and thrombocytopenia occur. • Stool examination • Increasing of red blood sells and leukocytes • Stool culture • Specimens should be plated lightly onto MacConkey, xylose-lysine-deoxycholate, or eosin-methylene blue agars. • Serological test in dynamics with fourfold title increasing in 10-14 days

  23. Shigella colonies

  24. Salmonellosis • an acute infectious disease of human and animals, that is caused by the numerous strains of Salmonella and more frequent courses as gastro-intestinal, rare – as typhoid or septic form

  25. Classification • Local form • Gastrointestinal form • Bacterium carrying • General form • Like typhoid fever • Sepsis • Asymptomatic form • Severity (mild, moderate and severe) • Course • acute (up to 1.5 mo) • subacute (up to 3 mo) • chronic (about 3 mo) IV. Complicated or uncomplicated

  26. Salmonella Infection typical color of feces, hemocolitis

  27. Salmonella Infection, severe hemocolitis

  28. Salmonella Infection Typhoid form

  29. Lab Studies: • Complete blood count with differential • Cultures: fecal, blood, urine, or bone marrow. • Stools examination: hemoccult positive and positive for fecal polymorphonuclear cells. • Chemistry: Electrolyte tests may reveal abnormalities consistent with dehydration. • Serologic tests in dynamics with fourfold title increasing in 10-14 days

  30. Dehydration

  31. Dehydration

  32. Breast feeding • In infants breast feeding must continue, those, who are bottle feeding – receive adopted milk formulas, better with low lactose content

  33. Lactose-free or dairy formulas

  34. Probiotics • during acute period and for 3-4 weeks in the recovery period

  35. Enterosorption • For 5-7 days, in case of stools normalization or constipation development enterosorption should be discontinued. • Smecta • Enterosgel • Polysorb

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