fever, diarrhea, abdominal cramps
DESCRIPTION
Crohn’s, acute ulcerative colitis, acute appendicitis. Incubation: 1-7 days. Incubation: 8-48 hrs. Millions/year USA. (can progress to bloody). 30-40% Guillan-Barre, USA. Reiter’s syndrome. - PowerPoint PPT PresentationTRANSCRIPT
Fever, diarrhea, abdominal cramps
Not much fever, diarrhea, cramps
3-5% HUS( up to wks after infx)
Most common cause acute kidey failure child
(can progress to bloody)
(leukocytes) lasts 5-10 days
Incubation: 1-7 days
30-40% Guillan-Barre, USA
Crohn’s, acute ulcerative colitis, acute appendicitis
Diagnose by:
Stool Culture
Incubation: 8-48 hrs
Nausea, vomiting, 50% have fever Abdominal cramps, diarrhea 2-4 d, Diarrhea, no pus. Self limiting 5-7 d
Reiter’s syndrome
Millions/year USA
73,000 cases/yr USA
Treatment:
Flush
Except systemic salmonella= amp/gent
CDT
Incubation: 1-7 days
30-40% Guillan-Barre, USA
Fever, diarrhea, abdominal cramps(leukocytes)
lasts 5-10 days
microaerophilic
CDT
LOS
Age Peaks
< 1yr 15-44
Serum resistance from surface protein
Gastroenteritis that may become systemic
Penicillin Ceph STX-TMP
C.
Acid tolerant pH 3-4
SPI-1
Mcell
SPI-2
Inhibits phago+lyso
ID 15-20
Salmonella enteritidis / typhimurium
16 million cases/yr
600,000 die
Asymptom carriers
Vaccine: Vi polysac capsule antigen (IM)
Ty21a- live, attenuated, oral
Peak: 5-12 yrs old
H antigen
incub 1-3 wks
Liver GallbladderCFTR receptor
Fecal-Oral Vi antigen
Incubation: 8-48 hrs
Reiter’s syndrome
Nausea, vomiting, 50% have fever Abdominal cramps, diarrhea 2-4 d, Diarrhea, no pus. Self limiting 5-7 d
Amp & Gent
CFA-2
CAF-4
CFA-1CFA-2
CFA-4
LT & ST
Secrete bacterial protein into cell….. PLC, IP3-, IL-8 Loss microvilli
TIR
LEE- intimin, contact dep secretion, TIR
STX
Gb3STX
Removes Adenine from 28S
0157:H7 Watery Bloody
Hemolytic Uremic Syndrome
1.Hemolytic anemia
2.Thrombocytopenia
3. Glomerular Thrombosis
4.“acute renal failure”
TX: Transfuse and hemodialysis
Develops in kids
DAEC
Dr fim
briae
STX-TMP Quin
STX-TMP Quin
NO Antibiotics
Pili
Little fever, no pus
Day 4 Day 6
EAEC - “Persistent Watery Diarrhea”Mostly in developing countries. VIRULENCE FACTORSAdherence – AAF pili (aggregative adherence fimbriae) and dispersin
Toxins – EAST: ST-like toxinPet: Serine protease.
Hemolysin: EIEC – “Distinctively Different”Invasion of epithelium. Similar to Shigellosis but less severe. Children under 5 in developing countries. Humans are sole reservoir. Virulence genes
Can lyse cell and spread laterally.
Quin STX-TMP
M a5B1
ISCA
IPaB ICE
IL-1
Shiga Toxin – ONLY released by cell lysis. DOES NOT kill the invaded mucosal cells. Toxin affects vascular tissues –BLOODY STOOLS.
Flexneri & dysenteriae
IL-8 …PMN
Quinolon 3rd Ceph
Host dies
Reiter’s Syndrome flexneri(3%) HLA-B27
Shiga toxin
Interrupts 28S rRNA
HIGH INFECTIVITY ~100 bugs sonnei
Food, fingers, feces, flies
VPI-1 Tcp pilli(CTX receptor) VPI-2 Neuramindase
& RIP 50%
Polysaccharide cap Protease Phospholipase
Generally self limiting 1-2 incubation
CTX
ZOT ACE
Cl-
Broad
Corynebacterium diphtheriae
(G+ rod)
(G+ rod)
Tetanospasmin- neurotox blocks glycine(inhib)
4-14 days incubation
tx: Abs to toxinClostridium difficile
(G+ rod)
Clostridium difficile
(G+ rod)
Clostridium botulinum
blocks Ach release
Zn protease
heat labile
Incubation 12h-8d
severe nausea
no fever
(G+ rod)
aerotolerantpain/heaviness
colitis and diarrhea 5-10 days after start of antibio or after discontinued
alpha toxin labile, spore not
lecithinase-myonecrosis
penicillin
Clostridium tetani
(60-90%)
Cranial nerve palsy
Blurred vision
sym. paralysis
exotoxin
Fusobacterium sp (G+ rod)
Anaerobic MeningtisPenicillin
18,000 cases/yr USA
Serratia marcescens
OH
O
H O
Room Temp
DNAse
B-lacamikacin
B-lactamaseCatheters herion user
Ferment lac motile, capsulefound pts tx with antibiots
diabetics and indwelling cath respiratory and UTI, burns
LPS
K & H antigen
ST & LT
B-lactamase
3rd Ceph
Klebsiella pneumonia (lobar)
OO antigen capsule
ST
LTB-lactam3rd Ceph
E. coli
UTI
meningitis
nonmotile No capsule
K-O-H
E. cloacae
Penicillin Cipro
BOTH
No
Granulomatosis infantiseptica
30-100%
Y. pseudoTB >
no diarrhea 75% 5-20 yr VERY RARE
large infectious dose= 1 million
MORTALITY: 50% 70%
L. monocytogenes
Amp
Internalin A Listeriolysin O PI-PLC ActA PC-PLC
Onset time~ 12 h
NO ST
Y. enterocolitica
1-2 day incubation
Enteric Fever
Rare
FEVER CHILLS SHOCK
STYops & V ag
inhibit phago MQ apoptosis
cytokine (IL-8,TNF,IFN) Reactive arthritis (small %) HLA-B27
M cells
Tetra Amino STX
liver
Streptococcus mutans Actinomyces israelii (G+ rod)
Helicobacter pylori
Anaeorobic, filamentous
Liver
Lung abscess
Skin
Clostridium difficile (G+ rod)
Propionibacterium acnes
(G+ rod)
Gingival crevice & female UGT
Penicillin
BabA
CagA
VacA
IL-8
LPS
Type II: NO CagA
Type I: Ulcers and Cancer Fecal-oral and contaminated H20
Proteus mirabilis, motile
“swarming”
Amp Ceph
Tetra
Bacteroides fragilis (G- rod)
Capsule
Collagenase
Hyaluronidase
GI & brain abscess, cellulitis
Metro Clind
B-lactam
Treponema pallidum
Perivascular infiltrate.
Penicillin Caution: JH rxn
L1,L2,L3
Doxy Erythro Enterococcus Faecalis
Intestinal & oral
OO
Tetra Erythro
Type III secretion inhibits phago+lyso
9 hrs
16-20 hrs
ATP-ADP translocase
No peptidoglycan
Long incubation 10-21 days
ABC- Africa/Blindness and chronic infx
D-K subtypes
R. rickettsii
transovarian tsmsmIncub 2-14 day Fever day 5 Rash day 3-12
IFA/latex biopsy
OmpA
Escape phagosome replicate in cytoplasm
actin tail filament propulsion
Endemic Typhus( R. typhi & R. felis)
50% rash by day 6, 50% no rashFlu like symptoms hacking non-productive cough X-ray shows pulm densities
10% ICU
STX-TMP,age, disease increases risk
R. prowazeki
Rash begins on upper trunk day 5, macular. Cough, confusion, stupor.
untreated
Refugee Camp- wash clothes>50 C
Brill-Zinsser-mild
Ehrlichia chaffeensis Lonestar Tick(Amblyomma americanum) Human Monocytic Ehrlichiosis(HME)
Anaplasma phagocytophilum Ixodes spp (Lyme, babesiosis, anaplasmosis)
Human Granulocytic Ehrlichiosis(HGE)
morulae
Flu like- rash rare
leuko/thrombopenia
RIP 25%
RIP 40%
RIP 2-5%
Tetra
Doxy
RMSF
ALL
NE
ED
CoA
and
NA
D fr
om H
ost
VlsE-surface, recombine
little/no spread via blood ass. with collagenous tissue persistent infxn
Early- Bell’s palsy, men, enceph Cardiac- AV node block, myo/pericarditis
Late- inflamm arthritis, 1 sided, large joint
Incubation 7-14 days(can be 3-30)
3 um
Borrelia hermsii
Endemic Tick-Borne Relapsing Fever
Ornithodoros spp soft tick
VMP(variable membrane protein)- recombination
40 C spikes
Incubation 1.5 wks
Giemsa stained blood
Borrelia recurrentis
Relapsing Fever
Louse crush juice Ethiopia
Fever, malaise. Similar to TBRF, but > fatality
Caution: J-H Rxn
LPS enter skin or mucus membrane
90% anicteric, flu like, men, 1-3 wks resolves 10% Weil’s syndrome: high fatality
SPFL
B-lac/Tetraoral
IVB-lac/tetra* 3-4 wks
B-lac tetra*
(hydrocorticoid & acetaminophen)
Coxiella burnetii (G- coccobacillus)
Q fever
PLAGUE
LcrV and YopsMouth & intestine
Obligate intracell, cytoplasm rep Spores
Dust, meat, tick, soil
Flu like, cough, pneumo + hepatitis
IFA, ELISA
Doxy
No rash
Day 3 Day 7 Day 10
Orietia tsutsugamushi
Atypical pneumo ARDS & DIC
lymphadenopathy Perivasculitis
Tetra
½ symptomatic
High fever(104) 1-2 weeks
RIP 1-2%
RIP 0-30%