gastroenteritis
red man syndrome
The concomitant use of opiates and vancomycin may increase the frequency of what syndrome?
cryptosporidium
This organism has a protective coating which can allow it to survive the normal clorination process used to control microbial growth in our drinking water
symptoms of gastroenteritis
Vary according to resistance Depend on type & quantity of microorganism ingested Often begin suddenly/often violently Loss of appetite Nausea/vomiting Abdominal rumbling/cramping/gas Diarrhea most common May be bloody or watery May have fever, aching muscles, extreme exhaustion
cytotoxin production
a mucosal destruction involved. ex. bloody stool relation to C.DIFF
what type of animal may carry gastroenteritis
a turtle may carry salmonella
colon
absorbs fluid and transports liquid fluid stool content to sigmoid colon.
how does an infectious agent causes diarrhea by adherence
adherence-when the infection adheres or attach and the absorption is affected/infection.
rotavirus
affects children causes terrible diarrhea we now have a vaccine so the rates has gone down significantly
what type of drugs may cause gastroenteritis
antiobiotics can cause this in susceptible people
what is the severe complication of gastroenteritis
dehydration
cryptosporidium
is very resistant to large concentrations of chlorine can be found in drinking contaminated water or recreational water such as the swimming pool
noravirus
it is extremely contagious, it can spread like wildfire think cruise ship outbreaks.
what does probiotics do for gastroenteritis
makes the duration shorter.
what do we give for C-diff
metronidazole or vancomycin
an example of exotic seafood that may cause gastroenteritis
raw oysters,shellfish
what do i need to watch for when infusing vancomycin and what to do if side effects occur
red man syndrome such as flushed cheeks and INCREASED HEART RATE run the vancomycin fairly slow
red man syndrome
red, flushed skin from histamine release, associated with rapid infusion of vancomycin (so slow down the infusion rate)
enterotoxin production causes diarrhea causes what
some bacteria such as E.coli some bacteria produces rice watery diarrhea ex. cholera.
how to diagnose gastroenteritis type of bacteria
stool test
small intestine is what
the prime absorbment surface
what type of acidic foods that may cause gastroenteritis
tomatoes citrus fruits such as orange
what can water be contaminted which causes gastroentetiris
water can be contaminated with arsenic lead mercury cadmium
mucosal invasion
when an infectious agent causes an infection in the mucosa
blood test for gastroenteritis
when the white blood cell is elevated
vancomycin side effect
*HYPOTENSION/ FLUSHING/ RASH IN FACE AND TRUnK (RED-MAN SYNDROME); OTOTOXICITY, NEPHROTOXICITY, WATCH VITAL SIGNS
etiology of gastroenteritis
179 million cases occur in US every year 80-85% DO NOT seek medical attention 1-2% require hospitalization
when does C.DIFF occur that causes gastroenteritis
C.diff occurs after treatments with antibiotics.
complications
Dehydration The very young, very old, & immunocompromised at most risk Hyponatremia Hypokalemia Shock Kidney failure
pathophysiology of gastroenteritis
Diarrhea is caused by infectious agents through: Adherence Mucosal invasion Enterotoxin production Cytotoxin production These mechanisms result in ↑↑ fluid secretion and/or ↓↓ absorption
parasites causing gastroenteritis
Giardia Invades the lining of the intestine Usually from contaminated water or person to person Cryptosporidium Drinking contaminated water (recreational water) Resistant to large concentrations of chlorine
diagnosis of gastroenteritis
History of contact with contaminated water or food or recent travel? Family member recently ill? Consumed raw seafood or had picnic food left out in the heat? Recent antibiotic use? May do stool tests for WBCs, bacteria, viruses, parasites
gastroenteritis
Infection or inflammation of the stomach and small and large Intestines Often called the "stomach flu" Highly contagious!
bacteria causing gastroenteritis
Less common than viral E coli & C-diff (produce enterotoxins) Many different subtypes of E coli C-diff occurs after treatment with antibiotics Salmonella and Campylobacter (most common bacterial causes) Undercooked poultry/unpasteurized milk Undercooked eggs or handling reptiles, birds, and amphibians
what type of viruses causes gastroenteritis
Most common cause in US Rotavirus (now a vaccine) Norovirus (think cruise ship outbreaks) Astrovirus Adenovirus
how is gastroenteritis transmitted
Person to person (wash your hands please!) Fecal-oral (Yuck!) Eating food or water contaminated with infected stool (double Yuck!) Eating uncooked or unpasteurized foods Ingesting contaminated water at a water park or in a pond Direct contact with animals that carry an organism
chemical toxins that may cause gastroenteritis
Poisonous mushrooms Exotic seafood Ingesting water contaminated with: Arsenic, lead, mercury, cadmium Can be caused by large amounts of acidic foods Citrus fruits and tomatoes
clinical manifestation of gastroenteritis
Primary manifestation is diarrhea, but can be accompanied by N/V & abdominal pain Severity may vary from mild & inconvenient to severe & life-threatening
vancomycin
Pt with breast cancer that is receiving chemo via indwelling CVC. Temp of 102.5, BP 90/50. No erythema around catheter site. Lungs are clear to auscultation. Labs: WBC 3200. Urine rbc 2, wbc 2, bacteria occasional. In addition to ceftazidime, empiric antibiotic therapy should include?
treatment of gastroenteritis
Rest Fluids & rehydration solutions If severe, may require hospitalization for IV therapy Sometimes antibiotics For traveler's diarrhea (E coli) For C-diff (metronidazole or vancomycin) Possibly probiotics Anti-emetics (Zofran)
what is the most common bacteria that causes gastroenteritis and it is from what
Salmonella and Campylobacter Undercooked poultry/unpasteurized milk undercooked eggs or handling reptiles, birds, and amphibians
