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) Rotavirus Coxsackie viruses ECHO (Enteric Cytopathogenic Human Orphan) viruses Astrovirus Parvovirus - Parasites Giardia lamblia Cryptosporidium

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)

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

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

Localisation of the process – in small intestinum

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.

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

stool cultures

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.

Etiology of Shigella Infection Shigella dysenteriae Shigella sonnei Shigella flexneri Shigella boydii

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

Localisation of the process

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

Toxicosis, marble skin

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

Sunken abdomen, dehydration

Shigella Infection false urge to defecate

Stools with greenish and mucous

Rectal spit

Rectal prolapse

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

Shigella colonies

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

Classification Local form General form Asymptomatic 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

Salmonella Infection typical color of feces, hemocolitis

Salmonella Infection, severe hemocolitis

Salmonella Infection Typhoid form

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

Dehydration

Dehydration

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

Lactose-free or dairy formulas

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

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