Symptoms

Diarrhoea fever headache

diarrhoea Fever

Diarrhoea

abdominal pain, vomiting,

tender abdomen

malaise, cramping

bloody abdominal pain

tenesmus, cramps, blood & mucous in stools Inflammation of ileum and colon Ulceration of intestine

Diseases/M icrobe

Salmonellasis

Typhoid fever

Campylobacter jejuni

Yersinosis

Shigellosis

S.enteritidis

Salmonella Typhi

Campylobacter jejuni

Yersinia enterocolytica

S. dysenteriae (Most severe) S. flexneri (less sever) S. sonnei (common,mild) S. boydii (rare) Reservoir humans Does not survive in the environment Faecal/ oral route Person to person Enrichment: selenite or gram negative (GN) broth Plate: MAC, XLD, Salmonella-Shigella agar, TSI & SIM Non-lactose fermenting, alkaline colonies Confirmation: biochemical or serological tests

Causes

poultry, eggs, cheese

faecal/oral route Faulty sewage systems

Contaminated meat especially raw or undercook pork products or unpasteurized milk

Sources

Culture: blood, bone-marrow or stool Enrichment: selenite broth Media Culture: XLD and BSA Confirmation: Biochemical tests

Culture: blood, bone-marrow or stool Enrichment: selenite broth Media Culture: XLD and BSA, Salmonella-Shigella agar, TSI & SIM Confirmation: Biochemical tests Antibody detection: Widal Test Main: Ceftriaxone Alternatives: Ampicillin, Chloramphenicol.

Laboratory Identification

Microaerophilic environment o (~5% O2), 42 C, Skirrows medium

best and motile at 25 C Confirmation: biochemical tests or serology

Treatment

Unnecessary, self-limiting

Aminglycosides, trimethoprim, cephalosporins

Ampicillin, chloramphenicol, trimethoprimare

 Symptoms

diarrhoea Can overgrow when patient is on broadspectrum antibiotics Often severe

diarrhea Nausea and explosive vomiting Begins 1-6 hours after ingestion Nausea and vomiting begin 1 to 5 hours after the contaminated food is eaten Duration: 6-24 hours

Watery diarrhea and abdominal pain 8-16 hours of incubation, after consumption of contaminated food Duration 12-24 hrs

diarrhoea Abdominal pains, cramps,

-12 hours after ingestion-severe diarrhea, abdominal cramps-loss fluid and electrolyte-intestinal epithelial damage caused by desquamation of epithelial cells at villustips -self-limiting

Bacteria/d iseases Causes

Clostridium difficile

Staphylococcal Food Poisoning S. aureus Normal flora, creams, tarts, custard processed food where competing bacteria are inhibited (ham)

Bacillus cereus (Vomiting syndrome)

Bacillus cereus (Diarrheal type)

Clostridium perfringens

B. cereus Boiled rice that is held Meat for prolonged period at vegetable dishes, ambient temperature sauces, and then quick-fried pasta, before serving desserts Dairy products dairy products Pasta Culture: Sheep Blood Agar -hemolytic frost-glass colonies Gram stain: long rods Spore stain positive Motile

Clostridium perfringens meat, stew etc

Sources

S. aureusis often undetectable (killed off during cooking) Latex agglutination test for enterotoxin Ironically treatment is by Metronidazole, vancomycin Possible newer therapy includes a probioticmilkshake containing L. bulgaricus, L. caseiand S. thermophilusto prevent diarrhea

Laboratory Identification

Nagleragar (egg yolk media) anaerobically Blood Agar: Beta-haemolytic

Treatment

Replace fluids & electrolytes Recovery usually in 24 hours

Unnecessary Self-limiting

intensive supportive (respiratory)

progressive muscle weakness flaccid paralysis Neurological symptoms: blurred vision-speech difficulties-descending flaccid paralysis

Symptoms

Weakness, dizziness, dryness of mouth, nausea, vomiting

Profuse diarrhea rice-water stools

2-48 hrs after ingestion (average 12 hours) abrupt severe (bloody) diarrhea with cramps

Abortions Meningitis Septicaemia

Bacteria/diseases Causes

Clostridium botulinum

Botulism

Cholera Vibrio cholerae

Vibrio parahaemolyticus

Listeriosis Listeria monocytogenes raw foods, such as uncooked meats, raw milk and vegetables, soft cheeses Pregnant women should avoid high risk foods such as pates, soft cheeses, unpasteurised dairy products and uncooked seafood. on HBA, -hemolytic, small white colonies-highly motileCAMP test, but smaller lysis zone

home preserved, alkaline food or commercial canning failures

Sources

spores in soils (and honey)

Faecal contamination of water or food

Food poisoning from sea food

Anaerobic culture Cooked meat media -10 days Non-hemolytic on blood agar Toxin: radioimmunoassay, ELISA

Fecal gram stain presumptive Enrichment: alkaline peptone water Plate: TBCS agar - yellow colonies Identification: serology Fluids and electrolytes -very important! Tetracycline may be given Reports of resistance

Treatment

Laboratory Identification

Differentiated from V. cholera green colonies on TCBS-needs NaClto grow

Diarrhoea ranging from mild to severe

Diarrhoea

Moderate to severe watery diarrhea

Symptoms

Inflammation of mucous layer of the stomach duodenal ulcers

Amoebic dysentery: mucous, pus and blood in faeces Complication Perforated intestine leading to peritonitis Trophozoite travels in blood to liver & forms abscess

abdominal cramps, nausea, vomiting, flatulence, greasy stools

May also have nausea, vomiting, abdominal cramps and lowgrade fever

Asymptomatic or vague intestinal discomfort

Usually self-limiting

Bacteria/d iseases

Helicobacter Pylori

Amoebic Dysentry

Giardasis

Cryptospridosis

Tapeworm Infestation

Causes

Entamoeba histolytica

Giardia Lamblia

Cryptosporidium parvum carried by man and other warmblooded animals fecal-oral; water contaminated with human or cattle feces

Taenia solium Taenia saginata

Cysts digested in food or water Sometimes also through anal sex

Food Water

Taenia solium (undercooked pork) Taenia saginata (undecooked beef)

Sources

Biopsy (clotest) breath test antibodies Microaerophillic, Skirrowsmedium, CHA, 37C for 3-6 days Amoxicillin, clarithromycin

Laboratory Identification

Microscopic examination: Four-nucleate cyst in stool Series of samples collected: differentiate from nonpathogenic species such as Entamoebacoli Metronidazole

Examination of stools for cysts

Examination of faecesfor oocysts Detected by floatation and acid-fast stain PCR Not treated unless patient is immunocompromised Spiramycincan be used

Examination of faeces for scolices

Treatme nt

Metronidazole, tinidazole Mepacrine hydrochloride

Niclosamide, praziquantel

Symptoms

Cysts

Itching

Intestinal bleeding anaemia& lethargy

Abdominal infection Pulmonary symptoms

Vomiting and diarrhoeafor 4-7 days Large number of virionsshed in faeces Cough and coryzaare quite common Rotavirus

Diarrheal disease Damages mucosa of small intestine

Bacteria/ diseases

Hydatid diseases (Tapeworm) Echinococcus granulosis

Nematode Infestation (pinworm) Enterobius vermicularis

Causes

Eggs in feces Cysts in organs

Pinworm Via contaminated fingers

Worm Infection (Hookworms & roundworms) Hookworm: Ancylostoma duodenale & Necator americanus Roundworm: Trichuris Hookworm: Soil-transmitted helminth: Infect by active skin penetration by infective larvae transmitted primarily by walking barefoot on contaminated soil. ingestion of larvae. Roundworm: undercooked pork

Ascariasis

Norovirus

Ascaris lumbricoides

Reovirusfamily

Caliciviridaefamily

undigested food

Faecal-oral route food & water, direct contact

Faecal-oral route E.g. shell-fish harvested from polluted water

Sources

Laboratory Identification

Examination of stools for adult pinworms microscopic examination for eggs Cysts must be surgically removed Pyrantelpamoate, mebendazole Medendazole Mebeddazole

Electron microscopy of faeces ELISA for viral antigen Fluid and electrolyte replacement essential Vaccines in trial

Electron microscopy of faeces ELISA

Treatment