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
Astrovirus Parvovirus
- 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 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 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 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

27. Salmonella Infection typical color of feces, hemocolitis

28. Salmonella Infection, severe hemocolitis

29. Salmonella Infection Typhoid form

30. 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 days

31. Dehydration

32. Dehydration

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

34. Lactose-free or dairy formulas

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

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