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Gastrointestinal infections
Microbiology
6
Biology
Graduate
09/16/2008

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Term

 

 

 

Vibro cholerae

Definition
Disease: cholera
Characteristics:
  • Comma-shaped gram-negative rods
  • Oxidase + (distinguished from Enterobacteriaceae)
Habitat and Trnasmission: Colon. Fecal-oral transmission
Pathogenesis: 
  • Enterotoxin
    • stimulates Gs to always be on
      • ↑ cAMP and results in massive watery diarrhea
  • Mucinase
    • enhances attachment to the intestinal
Clinical Features:
  • Watery diarrhea - no RBC's or WBC's
  • no abdominal pain
  • Dehydration and electrolyte loss leads to cardiac and renal failure
  • Acidosis and hypokalemia
Lab Dx: 
  • Gram negative rods culture
  • agglutination confirms
Tx: Fluid and electrolyte replacement
Prevention: Public health measures
 
Term

 

 

 

Bacillus cereus

Definition
Disease: Food poisoning
Characteristics: Aerobic gram + spore forming
Habitat and Transmission: Habitat is grains like rice.  Spores survie heating.
Pathogenesis
  • Enterotoxin
    • acts like cholera toxin
    • other acts like antigen (i.e. like staph enterotoxin)
Clinical Features:
  • short incubation
    • 4 hrs
    • nausea and vomiting
  • Long incubation
    • 18 hrs
    • water, nonbloody diarrhea (like clostridial gastroenteritis)
Lab Dx: Not done
Tx: Sx tx only
Prevention: No vaccine
Term

 

 

 

Salmonella enteritidis (Salmonella enterica)

 

 

Definition
Disease: Enterocolitis. Sepsis with metastatic abscesses sometimes.
Characteristics:
  • Facultative gram negative rods.
  • Lactose Negative
  • Motile (unlike Shigella)
Habitat and Transmission: enteric tract of humans and animals (Turtles). Fecal-oral transmission.
Pathogenesis: 
  • Invades mucosa
  • requires 105 organisms for infection.
  • inactivated by stomach acid
  • Risk factors: low acid in stomach (PPI's), sickle cell anemia risk for osteomyelitis
Clinical Features:
  • 12-48 hr incubation
  • Nausea and vomiting, abdominal pain and diarhea
  • sef-limited
Lab Dx:
  • Gram stain and culture.
  • Lactose Negative
Tx:Fluid and electrolytes
Prevention: public health measures
 
 
Term

 

 

 

Salmonella typhi or Salmonella paratyphi

Definition
Disease: Typhoid fever
Characteristics:
  • Facultative gram-negative rods.
  • Lactose Negative
  • H2S +
Habitat and Transmission: Human colon only. Fecal-oral transmission.
Pathogenesis: 
  • Infects retculoendothelial system (spleen and liver)
  • chronic carrier in gallbladder
  • Risks: low stomach acid
Clinical Features: 
  • Slow onset fever and constipation
  • 1st wk - high fever, delirium, tender abdomen, splenomegaly, Rose spots,
  • Leukopenia and anemia, abnormal LFT's
Lab Dx: 
  • Gram stain and culture
  • Lactose Negative
Tx: ceftriaxone
Prevention: Public health measures
 
 
Term

 

 

 

Shigella (S. dysenteriae, S. sonnei)

Definition
Disease: Enterocolitis (dysentery)
Characteristics: 
  • Facultative gram negative rods
  • Lactose negative
  • Non-motile (contrast to Salmonella)
Habitat and Transmission: Human colon only. No animal carriers. Fecal-oral transmission.
Pathogenesis: 
  • Invades the mucosa but not all the way through
  • Low ID50
  • Resistant to stomach acid
  • At risk: Children and mental institutions
Clinical Features:
  • 1-4 day incubation
  • fever, cramps, diarrhea (bloody)
  • 2 Factors
    • Species
      • S. dysenteriae is most virulent
      • S. sonnei most common in U.S.
    • Age
      • Children and elderly at increased risk
Lab Dx:
  • Gram stain and culture
  • Lactose Negative
  • No gas or H2S
Tx: Fluid and electrolytes
Prevention: Public health measures
 
Term

 

 

 

Camplylobacter jejuni

Definition
Disease: Enterocolitis
Characteristics: 
  • Comma-shaped gram negative rods
  • Mecroaerophilic
  • Grows well at 42°C
Pathogenesis:
  • Invades mucosa of colon - no penetration
  • No enterotoxin
Clinical Features:
  • Watery, foul-smelling diarrhea followed by bloody stools with fever and severe abdominal pain
  • Guillain-Barré syndrome association
    • Cross rxn b/w Ab's for C. jejuni and neurons
Lab Dx:
  • Gram stain and culture
  • grows at 42°C
Tx: Symptomatic tx only. Erythromycin for severe cases
Prevention: Public health measures
 
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