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Gastroenteritis - Coggle Diagram

- - - - Bloody stool
  - - - Non resolving immunocompromised cases
      - Azithromycin
      - Erythromycin
    - - 2-5 days
        Up to 10 days
  - - - Guy and the bears
        Asecending paralysis
    - - Invasive bear cub
  - - - Curved moustache
- - - - Enrich cT-SMAC NSF
    - - Sero-agglutination
    - - VT1
      - VT2
      - Reference lab WGS
- - - - Can be fatal
      - Shiga enterotoxin
      - Very low infx dose
  - - - Ciprofloxacin
        Plasmid mediated resistance occurs
      - MDR shigella
        
        Azithromycin
        
        Meropenem
- - - - Clindamycin
  - - - Signs of systemic toxicity SIRS
        
        High CC
        
        Rising lactate
        
        Hypotension requiring vasopressor therapy
        
        AKI
        
        Respiratory distress
  - - - Presents on all pathogenic C dif strains
      - Intestinal epithelium causing:
        Fluid secretion
        Inflammation
        Tissue necrosis
        Watery diarrhoea
      - Targets brush border enzymes
    - - Present on all pathogenic C. dif strains
      - Cytotoxic toxin
      - Cell death
        Colonic inflammation
    - - Deletion mutation results in 10x increase in toxin production
      - Hypervirulent strains
      - Antimicrobial strains 027
    - - Increased binding and enterotoxic activity
  - - - Vancomycin van with an open mouth and tongue
    - - Metro train metronidazole
- - - - Invasive disease
  - - - IV antimicrobials
- - - - Vivrio sp
      - Enterotoxigenic E. coli (ETEC)
    - - Adhere to intestinal mucosa but do not invade
      - Toxins impair intestinal absorption and cause secretion of electrolytes and water by stimulating adenylate cyclase
      - Watery diarrhoea :droplet:
  - - - S. aureus
      - Bacillus cereus
      - Clostridium perfringens (rapid onset) :rabbit2:
  - - - Shigella
      - Salmonella
    - - Secretion of electrolytes and water
      - Bloody diarrhoea :red_circle:
      - Invade mucosa causing ulceration, bleeeding and exudation of protein rich fluid
- - - - Acute diarrhoea mild - moderate
      - May be vomiting
    - - <3 yrs
      - Wintermonths
    - - Rotavirus vaccine
        Childhood vaccination schedule
        2 and 4 months
    - - Rotavirus PCR stool
  - - - Winter vomiting bug
      - Highly contangious
    - - Diarrhoea
      - Vomiting
      - Nausea
      - Abominal pain
    - - Novovirus PCR
    - - Supportive and IPC measures
- - - - Campylobacter
      - Salmonella spp
        (non typhi / paratyphi)
      - VTEC / EHEC
      - Shigella spp
      - S. aureus
        ACUTE
      - C. perfringens
        ACUTE
      - B. cereus
        ACUTE
      - V. cholerae
      - Listeria monocytogenes
      - C. botulinum
      - C. difficile
        ANTIBIOTIC EXPOSURE
    - - Rota virus
      - Noro virus
      - C
    - - Cryptosporidia
      - Giardia lamblia
    - - Foodborne
      - Waterborne
      - Sporadic cases
      - Person-person
- - - - Children
      - Diarrhoea
      - Nausea
      - Vomiting
      - Severe illness in immunocompromised AIDS
    - - Contaminated wter containing cysts of C. parvum and C. hominis
      - Infected animals (cattle) and humans
    - - C. parvum
      - C. hominis
    - - Resistant to chlorine
    - - Cyts in stool
      - Acid fast
      - PCR
    - - No specific treatment
      - EPA water monitoring
  - - - Giradia lamblia
    - - Ingestion of cysts in contaminated food/ water
      - World wide
      - Pork
      - Wild and domestic animals
      - Soil
    - - Resists chlorination - thick outer shell
      - Cysts develop into trophozoties in duodenum
    - - Cramping abdomin pain
      - Flatulence
      - Floating diarrhoea
    - - Cysts or trophozoites in stool
      - Stool concentration / PCR
      - 3 samples
      - Duoudenal aspirate
      - Small bowel biopsy
    - - Metronidazole