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Major causes of GI Infection:
teeth?
oral?
Stomach?
jejunum,ileum?
large intestine?
- teeth=caries
- oral=stomatitis
- stomach=gastrinitis
- jejunum,ileum=enteritis
- large intestine=colitis
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Dental Caries
Causes?
Signs/Symptoms?
Pathogens?
Treatment?
Etiology?
- causes= gram + coccus in chains & other bacteria
- symptoms= S mutans/enamel/dental plague/caries
- pathogens=
- *sucrose + S. mutans : glucose&fructose
- *glucose + S. mutans: dextran (attachement factor)
- *fructose+ S. mutans: lactic acid (attack enamel)
- treatment= drilling & filling
- etiology= normal flora + sucrose
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Gingivitis to Periodontitis (anaerobes)
causes?
symptoms?
pathogens?
diagnosis?
treatment?
etiology?
- causes= Porphyromonas+ other bacteria
- also spirochetes, amoebae & trichomonads
- symptoms= bleeding gums to tooth loss
- pathogens= right combination of the above bacteria
- diagnosis= appearance of gums
- treatment= removal of calculus & plague, antibiotic therapy
- etiology= normal flora
**can be prevented by good brushing & flossing
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Stomatitis
causes?
etiology?
- causes= Candida albicans (thrush)
- etiology= opportunists
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Mumps Virus
causes?
symptoms?
pathogens?
diagnosis?
treatment?
etiology?
- causes= ssRNA enveloped; one serotype
- symptoms= painful parotitis in 70%
- -grbrt, chills, headache, malaise
- pathogens= viremia seen above age 1
- diagnosis= sympotomatic, ELISA
- treatment= MMR (live attenuated; 95% effective contraindicated during pregnancy)etiology= humans only-saliva: 2M USA without vaccine
- -a dangerous complication is painful unilateral orchitis in 20-35% of post puberty males
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Bacterial Food Poisoning
(Staphylococcus aureus)
causes?
symptoms?
pathogens?
diagnosis?
treatment?
etiology?
- causes= gram + coccus, catalase +, coagulase +
- symptoms= severe nausea, emesis & diarrhea
- pathogens=heat stable enterotocin (withstands 100 degrees C for 30 min)
- diagnosis= ingestion 1-6 hours, symptoms for 8 hourstreatment= not necessary
- etiology= improper food handling, preparation, storage*****
**similar sympotoms caused by C. perfringens 12-36 hours after ingestion
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GI Disease Terminology:
Intoxication
Ingestion of pre-formed toxin & resulting signs & symptoms
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GI Disease Terminology:
Infection
Pathogen enters the GItract & multiplies
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GI Disease Terminology:
Toxico-infection
Pathogen enters the GI tract, multiples & produces a toxin in GI tract, causing illness.
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GI Disease Terminology:
Dysentery
Severe diarrhea accompanied by blood or mucus
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Enterocolitis (salmonellosis)
(Salmonella enteritidis)
causes?
symptoms?
pathogens?
diagnosi?
treatment?
etiology?
- causes= gram - rod, 2000 serovars
- symptoms= nausea, crampy abdominal pain, diarrhea, moderate fever
- pathogens= ingestion 12 to 48 hours/ toxicoinfection to enterotoxindiagnosis= culture & ID, lactose
- treatment= rehydration & bland diet
- etiology= fecal- oral; sanitary food preparation, eggs & poultry, tomatoes, peanut better, pistachios, red pepper
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Typhoid Fever "enteric fever"
(Salmonella typhi)
causes?
symptoms?
pathogens?
diagnosis?
treatment?
etiology?
- causes= gram - rod
- symptoms= high fever & headache first, diarrhea in 2nd& 3rd week, fever declining
- pathogens= ingestion for 10- 14 days- infection to septicemia and mortality in 1 in 5 ppl if not treated
- enterotoxin, endotoxindiagnosis=blood culture&ID, lactose
- treatment= Ceftriaxone, supportive therapy, live attenuated oral vaccine (70% effective)
- etiology= 400 to 500 cases per year, oral-fecal route, gall bladder carries, sanitary food preperation
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Food Poisoning (also gas gangrene)
(Clostridium perfringens)
causes?
symptoms?
pathogens?
diagnosis?
treatment?
etiology?
- causes= anaerobic gram + rod, endospore
- symptoms= stomach cramps & diarrhea for up to 24 hours
- pathogens= ingestion for 8 to 12 hours, toxin, symptoms for 24 hours
- diagnosis= symptomatic
- treatment= no treatment, not fatal
- etiology= commonly in meats,desserts, salads
- **Toxin is heat labile
- ***Contrast with heat stable toxin from S.aureus food poisoning 1-6 hours after ingestion
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Special Situations:
#1 problem is a needle stick or shaprs injury by what agent?
HBV
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Special Situations:
What is herpetic whitlow?
Herpetic whitlow from HSV 1 on hands of health care workers with oral fluids contact.
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Special situations:
What are aerosol transmissible?
TB, Influenza Virus, & Rhinovirus are aerosol transmissible so any association is a risk.
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Name some standard precautions.
- -Gloves for all touching. change gloves between patients
- -Always use good antisepsis and disinfection
- -Masks, gowns. and eye protection for droplet generating procedures.
- -Hand-washing before and after all invasive procedures, or if contaminated with body fluids and after gloves are removed
- -Observe sharp object precautions
- -All blood & body fluids (BBF) containers should be considered potentially contaminated.
- **therefore wipe off with chlorox disinfectant
-Infectious wastes should be place in biohazard or infectious waste containers
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Infectious Hazards for Health Care Workers:
Name some blood- borne pathogens or bodily fluids.
- -CMV
- -Hepatitis B Virus
- -Hepatitis C Virus
- -HIV
- -Ebola
***Organisms of Bioterrorism
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Infectious Hazards for Health Care Workers:
Name some airborne pathogens.
- -tuberculosis
- -neisseria meningitidis
- -influenza
- -SARS
- -chickenpox
- -smallpox*****
***Organisms of Bioterrorism
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Infectious Hazards for Health Care Workers:
Name some other pathogens.
- -Bacillus anthracis
- -Francisella tularensis
***Organisms of Bioterrorism
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Name some airborne precautions.
- -Private negative ire pressure room, doors closed
- -N95 dust/mist mask for all persons entering room
- -Wash hand before entering room and upon leaving
- -Glove and gown as per Standard precautions
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Isolation Categories: Airborne
negative pressure?
mask?
gown?
gloves?
- neg pressure= yes
- mask= yes
- gown= sometimes
- gloves= sometimes
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Isolation Categories: Contact
negative pressure?
mask?
gown?
gloves?
- negative pressure= no
- mask= sometimes
- gown= yes
- gloves= yes
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Isolation Categories: Droplet
negative pressure?
mask?
gown?
gloves?
- negative pressure= no
- mask= yes
- gown= sometimes
- gloves= sometimes
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Name some contact precautions.
- -Patients with same organism in same room, private recommended
- -Wash hands before entering room & upon leaving. Also before and after glove removal and between patients
- -Gown at all times
- -Mask as per standard precautions
- (suctioning, dressing changes, etc)
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Name some droplet precautions.
- -Private room necessary
- -Wash hands before and after entering room.
- -Glove and gown appropriate
- -Strict isolation= airborne + contact + droplet
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Weekly Report is called what?
Mortality & Morbidity Weekly Report
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Sexually Transmitted Diseases:
Syphilis
(Treponema pallidum)
causes?
symptoms?
diagnosis?
treatment?
etiology?
- causes= gram - spirochete, no culture
- symptoms=
- Primary stage day 10 = genital chancre for a male & asymptomatic internal for a female
- -this goes away after 4-6 weeks
- -possible enlarged lymph nodes
- Secondary 6-12 weeks=
- fever, rash, sore, throat, malaise, anorexia
- Tertiary Stage 10 years-
- gumma
diagnosis= presence of spirochetes in chancre for primary or in rash for secondary
- treatment= Bicillin (long lasting benzathine penicillin)
- etiology= STD, also vertical to congenital syphilis
- -pre-natal screening mandatory
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Nongonococcal Urethritis (NGU)
(Chlamydia trachomatis)
causes?
symptoms?
pathogens?
diagnosis?
treatment?
etiology?
- causes= gram - rod, ATP parasite
- symptoms= same but milder than gonorrhea
- pathogens= intracellular
- diagnosis- endocervical or urethral swab, urine
- treatment= single dose of 1 gram of azithromycin orally
- etiology= 2-3 times more common than gonorrhea
- females that go undiagnosed can face fertility problems
- -in 2009: 1,244,180 reported cases in USA
- -LGV fever and lymphadenopathy caused by serotypes L1,L2,L3
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Lymphogranuloma venereum
(Chlamydia trachomatis)
causes?
symptoms?
pathogens?
diagnosis?
treatment?
etiology?
- causes= gram negative rod
- symptoms= chancre, malaise, fever, chills,rash, inguinal lymphadenopathy (may rupture)
- pathogens= invasive strains L1 L2 L3
- diagnosis= gen prove for chlamydia trachomatis from pus draining in lymph node
- treatment= tetracycline, erthromycin and sulfamethoxazole
- etiology= rare in USA usually found in tropic and subtropic areas
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Chancroid
(Hemophilus ducreyi)
causes?
symptoms?
pathogens?
diagnosis?
treatment?
etiology?
- causes= gram negative rod
- symptoms= painful soft chancre 2-5 days after exposure
- pathogens= exotoxin
- diagnosis= immunochromatography PCR
- treatment= Azithromycin, ceftriaxone
- etiology= tropical and subtropical cases
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Urinary Tract Infections & STDS:
Anatomy of Urinary Tract.
urethra>bladder>ureter>kidney>SEPTICEMIA
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Urinary Tract Infections & STDS:
UTI
(E.coli)
causes?
symptoms?
pathogens?
diagnosis?
treatment?
etiology?
- causes= other gram negatives from GI tract
- -Staphylococcus, entertoccocis faecalis, candida albicans
- symptoms=
- uncomplicated: dysuria, urgency and frequency, pyruria
- complicated= toxemia, kidney stones
- pathogens= community acquired is ascending aided by motility and fimbriae
- urethritis>cystitis>pyelonephritis>septicemia>shock
- pathogens=nosocomially acquired via urinary catheter
- diagnosis= clean catch uringe speciman, culture , ID
- treatment= TMP SMZ, fluoroquinilone for E.coli
- etiology= normal flora,
- risk factors= birth control, pregnancy, sex
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