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Gastroenteritis in children (Complications (Reactive complications …

- - - - Pathophysiology
        Lives as part of normal intestinal flora
        Some strains (verocytotoxin producing/VTEC/ enterohaemorrhagic) produce toxins causing illness
        Transmission by food (meat, milk, veg), faecal-oral, animal contact
        E Coli O157:H7 can progress to haemorrhagic colitis,
        which can be fatal in infants, eldelry or immunocompromised
        Haemorrhagic colitis can progress to haemolytic uraemic syndrome (severe, 10% mortality)
      - Clinical presentation
        Abdo pain
        Diarrhoea (can progress to bloody)
      - Complications
        Haemorrhagic colitis
        Haemolytic uraemic syndrome (HUS)
        Sepsis
    - - Pathophysiology
        Caused by S typhimurium, S enteriditis
        Infected animal/human faeces in env/food/water
        e.g. meat, raw eggs, milk
        Incubation 12-72h, lasts 4-7d
      - Clinical presentation
        N+V
        Diarrhoea (watery, sometimes bloody)
        Abdominal pain
        Headache
      - Epidemiology
        Most salmonella infections are non-typhoid types
      - Complications
        Septic arthritis
        Sepsis
    - - Epidemiology
        Commonest bacterial gastroenteritis
      - Pathophysiology
        C jejuni and C coli mostly
        Foods - undercooked meat, unpasturised milk, others
        Incubation 2-5d, lasts 1 week
      - Clinical presentation
        Asymptomatic
        N+V
        Abdo pain
        Fever
        Diarrhoea (+/- blood)
    - - Pathophysiology
        4 species
        Transmitted by faecal contamination of water
        Incubation 1-2d, lasts 5-7d
        Can be severe in infants, elderly, immunicompromised
      - Clinical presentation
        Asymptomatic
        Diarrhoea (blood + mucous i.e. dysentry)
        Fever
        Abdominal pain
      - Complications
        Haemolytic uraemic syndrome (HUS)
        Sepsis
    - - Epidemiology
        Rare
        Commonly young children
      - Clinical presentation
        Diarrhoea (watery, bloody)
        Fever
        Abdominal pain
      - Pathophysiology
        Transmitted by direct contact (animals/humans/food)
        Onset 4-7d, lasts 1-3w
      - Complications
        Rash
        Arthralgia
        Sepsis
  - - - Clinical presentation
        Diarrhoea (blood +mucous; dysentry)
        Severe abdo pain
        Fever
      - Complications
        Liver abscess
        Lung/brain infection
      - Pathophysiology
        Entamoeba histolytica
        Colonises intestine, can spread to liver, lungs, brain
    - - Epidemiology
        Common cause of travellers diarrhoea
      - Pathophysiology
        Direct contact humans/animals contam food/water
        Can last over 2-6 weeks
      - Clinical presentation
        Diarrhoea
        Malabsorption, weight loss
        Abdo pain
        Nausea
        Flatulence, bloating
        Anorexia
    - - Clinical presentation
        Diarrhoea (watery)
        Abdo pain
        N+V
        Fever
      - Epidemiology
        Leading cause of infectious diarrhoea
        Sometimes traveller's diarrhoea
      - Pathophysiology
        Animal or human (contaminated env.water/food)
        Lasts 1-2 wk
        Can be life threatening in immunocompromised
  - - - Epidemiology
        Commonest viral gastroenteritis (all ages)
        Outbreaks in institutions/confined spaces
      - Pathophysiology
        Faecal-oral, contaminated surfaces/food/water
        Short lasting immunity (can be reinfected)
        Lasts 12h-3d
      - Clinical presentation
        Nausea +/- vomiting
        Diarrhoea (watery)
        Fever, myalgia, headache
    - - Epidemiology
        Second commonest cause of
        gastroenteritis in children
    - - Clinical presentation
        Fever
        Vomiting
        Diarrhoea (watery)
      - Prevention
        Rotavirus immunisation (PO)
      - Epidemiology
        Commonest cause of infant gastroenteritis
        All UK children <5y
      - Complications
        Dehydration
        Toxic megacolon
        GBS
      - Pathophysiology
        Faecal-oral or env contamination
        Long lasting immunity (don't get as adults)
        Lasts 3-8d