Whipple's Disease and Tropical Sprue

by Carlo Raj, MD

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    00:01 Shigella, bloody diarrhea, bacteremia, ampicillin-resistant strains could be treated with chloramphenicol.

    00:10 Chloramphenicol pretty much avoided in the US.

    00:12 However, chloramphenicol extremely common to be administered in the developing world.

    00:19 Keep that in mind. That´s important.

    00:22 You will get a question on chloramphenicol and some ways should perform.

    00:25 You`ve heard of Gray Baby Syndrome, you´ve heard of aplastic anemia and chlormaphenicol.

    00:31 Even to this day, developing countries, chloramphenicol extremely common.

    00:35 Salmonella, we have the typhimurium most common in the US associated with poultry.

    00:42 Treatment: Mild symptoms and ultimately we have cipro.

    00:49 Parahemolyticus: ingestion of undercooked shellfish as I mentioned earlier.

    00:55 Antibiotic: may or may not be of value and we have E. coli or EHEC and hemorrhagic.

    01:06 And at this point, I would think that you have 0157: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.

    01:20 In a child, next step of management, my goodness you choose hemodialysis with antibiotic at the same time. Hemodialysis next step of management HUS, forevermore? Thank goodness, no. You´ll kill off the bacteria in the child and the child comes back to be perfectly normal. That makes me happy.

    01:38 When a child gets sick it´s not nice. Antibiotic therapy: not necessarily effective.

    01:43 Hence, the hemodialysis. Staph. aureus, here we have extremely rapid, rapid, rapid type of diarrhea that we talked about. Enterocolitis with positive stool culture.

    01:57 Yersinia enterocolitica, chronic enteritis can mimic your Crohn´s, could be associated with ankylosing spondylitis. Treatment here is your cotrimoxazole.

    02:11 Campylobacter jejuni, extremely common and mimics once again your ulcerative colitis.

    02:19 We have Vibrio vulnificus, raw shellfish or wound infection.

    02:26 I was talking to you about this earlier when I was referring to the gulf.

    02:30 So, vulnificus-gulf. If you wanna call it 'gulfnificus'.

    02:36 That might perhaps help you and the wound infection is what happens here.

    02:40 It enters and take a look, I told you mortality increases to the point where this is exactly what happens. Necrotizing fasciitis in cirrhotics, vulnificus.

    About the Lecture

    The lecture Whipple's Disease and Tropical Sprue by Carlo Raj, MD is from the course Small and Large Intestine Diseases.

    Included Quiz Questions

    1. PAS - positive granules in small bowel biopsy
    2. Complete atrophy of villi in small bowel biopsy
    3. Partial atrophy of villi in small bowel biopsy
    4. Transmural inflammation with crypt abscess
    5. Damaged crypts and microgranulomas
    1. Gram-positive bacilli
    2. Gram-negative bacilli
    3. Gram-positive cocci
    4. Gram-negative cocci
    5. Acid fast bacilli
    1. Folate deficiency anemia
    2. Iron deficiency anemia
    3. Anemia of chronic disease
    4. Hemolytic anemia
    5. Sideroblastic anemia
    1. PCR analysis for bacterial DNA
    2. Biopsy of the intestine
    3. Colonoscopy
    4. Stool culture
    5. Western blot for bacterial proteins
    1. Urethritis
    2. Lymphadenopathy
    3. Arthritis
    4. Abdominal pain
    5. Neurological deficits

    Author of lecture Whipple's Disease and Tropical Sprue

     Carlo Raj, MD

    Carlo Raj, MD

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