bacterial enterocolitis
DESCRIPTION
BACTERIAL enterocolitis. Ingestion of bacterial toxins Staph Vibrio Clostridium Ingestion of bacteria which produce toxins Montezuma’s revenge (traveller’s diarrhea), E.coli Infection by enteroinvasive bacteria Enteroinvasive E. coli (EIEC) Shigella Clostridium difficile. E. coli. - PowerPoint PPT PresentationTRANSCRIPT
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BACTERIAL enterocolitis• Ingestion of bacterial toxins– Staph– Vibrio– Clostridium
• Ingestion of bacteria which produce toxins– Montezuma’s revenge (traveller’s diarrhea), E.coli
• Infection by enteroinvasive bacteria– Enteroinvasive E. coli (EIEC)– Shigella– Clostridium difficile
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E. coli• Toxin, invasion, many subtypes• Food, water, person-to-person• Usually watery, some hemorrhagic• INFANTS often, in epidemics
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SALMONELLAFood, not hemorrhagic
SHIGELLA(person-to-person, invasive, i.e.,
often hemorrhagic)
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CAMPLYOBACTER• Toxins, Invasion
• Food spread
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YERSINIA (enterocolitica)
• Food• Invasion• LYMPHOID REACTION
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VIBRIO cholerae
• Water, fish, person-to-person• Cholera epidemics• NO invasion (watery)• ENTEROTOXIN
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CLOSTRIDIUM DIFFICILE
• CYTOTOXIN (lab test readily available)• NOSOCOMIAL• PSEUDOMEMBRANOUS (ANTIBIOTIC
ASSOCIATED) COLITIS
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MALABSORPTION• INTRALUMINAL• BRUSH BORDER (microvilli)• (TRANS)EPITHELIAL• OTHER– REDUCED MUCOSAL AREA: Celiac, Crohns– LYMPHATIC OBSTRUCTION: Lymphoma, TB– INFECTION– IATROGENIC: Surgical
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INTRALUMINAL• PANCREATIC• DEFECTIVE/REDUCED BILE• BACTERIAL OVERGROWTH
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BRUSH BORDER• DISACCHARIDASE DEFICIENCY• BRUSH BORDER DAMAGE, e.g., by bacteria
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(Trans)EPITHELIAL• ABETALIPOPROTEINEMIA• BILE ACID TRANSPORTATION DEFECTS
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CELIAC DISEASE
• Also called SPRUE• Also called NON-tropical SPRUE• Also called GLUTEN-SENSITIVE ENTEROPATHY– Sensitivity to GLUTEN, a wheat protein, gliadin– Immobilizes T-cells– Also in oat, barley, rye– Progressive mucosal “atrophy”, i.e. villous flattening– Relieved by gluten withdrawal
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CELIAC DISEASE
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“TROPICAL” SPRUE
• Epidemic forms• NOT related to gluten, cause UN-known• RECOVERY with antibiotics
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WHIPPLE’s DISEASE
• DISTENDED MACROPHAGES in the LAMINA PROPRIA
• PAS positive• ROD SHAPED BACILLI
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WHIPPLE’s DISEASE
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DISACCHARIDASE DEFICIENCY
• LACTASE by far MOST COMMON• ACQUIRED, NOT CONGENITAL• LACTOSE GLUCOSE + GALACTOSE • LACTOSE (fermented)XXXXXXXXX• OSMOTIC DIARRHEA
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ABETALIPOPROTEINEMIA
• Autosomal recessive• Rare• Inability to make chylomicrons from FFAs
and MONOGLYCERIDES• Infant failure to thrive, diarrhea,
steatorrhea
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ANGIODYSPLASIA• NOT really “dysplasia”• NOT neoplastic• TWISTED, DILATED SUBMUCOSAL VESSELS, can
rupture!• Common X-ray finding