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Invasive Bacterial Diarrhea

by Carlo Raj, MD
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    00:00 Lets talk about some important invasive bacterial diarrhea. What you can expect clinically and how you would manage your patient effectively. Shigella. Now, shigella is rather interesting.

    00:11 And the reason for that is because there is certain recommendations that are made by CDC.

    00:16 But without going into too much detail, lets just make sure I give you just enough so you know what's going on. Number 1, bloody diarrhea with fever and bacteremia. Well you've heard of something called shiga toxin or shigella dysenteriae type I which very much behaves like EHEC or Enterohemorrhagic E.coli associated with HUS. If the patient and a proper targeting has been done, a susceptibility test, then ampicillin could be used along with your trimethoprim-sulfamethoxazole. However, there is an increasing tide of resistance taking place with such antibiotics. So with that said, drugs that you are now considering other placement include azithromycin, maybe fluoroquinolones. Salmonella typhimurium is the most common in US. Associated with poultry, non-bloody diarrhea. Treatment of mild symptoms may lead to prolonged carrier state and here your management would be ciprofloxacin.

    01:26 Parahemolyticus, ingestion of undercooked shellfish as I mentioned earlier. Antibiotic may or may not be of value. And we have the E.coli or EHEC and hemorrhagic. And at this point I would think that you have O157:H7 memorized. Undercooked beef is what you're thinking about. Bloody diarrhea in a child, hemolytic uremic syndrome. Uremia to you should mean renal failure. In a child next step of management, my goodness you choose hemodialysis with antibiotic at the same time.

    02:02 Hemodialysis, next step of management, HUS. Forever more? Thank goodness no. You kill of the bacteria in the child then the child comes back to be perfectly normal. That's what makes me happy.

    02:13 When a child gets sick, that's not nice. Antibiotic therapy not necessarily effective hence the hemodialysis.

    02:20 Staph. aureus, here we have extremely rapid, rapid,rapid type of diarrhea that we talked about.

    02:30 Enterocolitis with positive stool culture. Yersinia enterocolitica. Chronic enteritis. Can mimic your Crohn's.

    02:39 Could be associated with ankylosing spondylitis. Treatment here is your co-trimoxazole.

    02:45 Campylobacter jejuni. Extremely common and mimics once again your ulcerative colitis.

    02:55 We have vibrio vulnificus. Raw shellfish or wound infection. I was talking to you about this earlier when I was referring to the gulf. So vulnificus gulf, if you want to call it gulfnificus, that might perhaps help you. And the wound infection is what happens here. It enters and take a look, I told you mortality increases to the point where this is exactly what happens. Necrotizing fascitis in cirrhotics. Vulnificus.


    About the Lecture

    The lecture Invasive Bacterial Diarrhea by Carlo Raj, MD is from the course Small and Large Intestine Diseases.


    Included Quiz Questions

    1. Chloramphenicol
    2. Repeat dose of ampicillin
    3. Nitrofurantoin
    4. Azithromycin
    5. Amoxicillin
    1. Salmonella typhimurium
    2. Salmonella enteritidis
    3. Salmonella paratyphi
    4. Salmonella bongori
    5. Salmonella typhi
    1. Vibrio parahemolyticus
    2. Vibrio cholerae
    3. Shigella
    4. Enterotoxigenic Escherichia coli
    5. Enteroinvasive Escherichia coli
    1. O157: H7 strain of Escherichia coli
    2. Enterotoxigenic Escherichia coli
    3. Salmonella
    4. Shigella
    5. Vibrio parahemolyticus
    1. Salmonella
    2. Bacillus cereus
    3. Campylobacter jejuni
    4. Vibrioparahemolyticus
    5. Enterohemorrhagic Escherichia coli
    1. O157: H7 strain of Escherichia coli
    2. Enterotoxigenic Escherichia coli
    3. Campylobacter jejuni
    4. Vibrioparahemolyticus
    5. Salmonella
    1. Crohn's disease
    2. Ulcerative colitis
    3. Ischemic bowel disease
    4. Colon cancer
    5. Pseudomembranous colitis
    1. Necrotizing fasciitis
    2. Necrotizing enterocolitis
    3. Necrotizing lymphadenitis
    4. Necrotizing pancreatitis
    5. Necrotizing granulomas

    Author of lecture Invasive Bacterial Diarrhea

     Carlo Raj, MD

    Carlo Raj, MD


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