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Pathogenesis of diarrhea in food poisoning
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Non- inflammatory diarrhea
• The action of enterotoxins on the secretory mechanisms of the mucosa of the small intestine (no invasion).
• Large volume watery stools (no blood, pus, or severe abdominal pain).Dehydration.
• -The enterotoxins may be either preformed before ingestion or produced in the gut after ingestion.
Examples -Vibrio cholerae, enterotoxic Escherichia coli, Clostridium perfringens, Bacillus cereus, Staphylococcus organisms , Giardia lamblia, Cryptosporidium,rotavirus, norovirus (genus Norovirus, previously called Norwalk virus), and adenovirus.
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Inflammatory diarrhea• the action of cytotoxin on the mucosa, leading to invasion and
destruction. The colon or the distal small bowel commonly is involved.
• bloody stool ; mucoid and leukocytes are present. Fever or toxic smaller stool volumes.
• Fecal leukocytes test or a positive stool lactoferrin test• Sometimes, the organisms penetrate the mucosa and proliferate
in the local lymphatic tissue, followed by systemic dissemination.
Examples- Campylobacter jejuni, Vibrio parahaemolyticus, enterohemorrhagic and enteroinvasive E coli, Yersinia enterocolitica, Clostridium difficile, Entamoeba histolytica, and Salmonella and Shigella species.
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• In some types of food poisoning (eg, staphylococci, B cereus), vomiting is caused by a toxin acting on the central nervous system.
• The clinical syndrome of botulism results from the inhibition of acetylcholine release in nerve endings by the botulinum.
• some of the noninfectious causes of food poisoning (naturally occurring substances [eg, mushrooms, toadstools] and heavy metals [eg, arsenic, mercury, lead] acute GIsymptoms