[23] Bacterial Gastroenteritis

Question 1

What is bacterial gastroenteritis?

Answer 1

An inflammation of the stomach and intestines caused by bacterial infection in the gut

Question 2

When is bacterial gastroenteritis most common?

Answer 2

Under 2 years of age

Question 3

What kind of diarrhoea does bacterial gastroenteritis cause?

Answer 3

Secretory and inflammatory

Question 4

What are the sources of infection in bacterial gastroenteritis?

Answer 4

• Contaminated water
• Poor food hygiene, e.g. meat, fresh produce, previously cooked rice
• Faecal-oral route

Question 5

What are the common causative organisms for bacterial gastroenteritis?

Answer 5

• Salmonella spp.
• Campylobacter jejuni
• Shigella spp.
• Yersina enterocolitica
• E. Coli
• C. Difficile
• Bacillus cereus
• Vibrio cholerae

Question 6

How does bacterial gastroenteritis present?

Answer 6

Same as viral, plus;

• Malaise
• Dysentery
• Abdominal pain
• Tenesmus

Question 7

What is dysentery?

Answer 7

Bloody and mucous diarrhoea

Question 8

What might the abdominal pain in bacterial gastroenteritis mimic?

Answer 8

• Appendicitis

- IBD

Question 9

What investigations are done into bacterial gastroenteritis?

Answer 9

• Stool +/- blood culture
• Stool C. Difficile toxin
• Sigmoidoscopy if IBD or colitis suspected

Question 10

What are the differentials for bacterial gastroenteritis?

Answer 10

Same as viral

Question 11

What is the management for bacterial gastroenteritis?

Answer 11

Rehydration as for viral gastroenteritis

Question 12

Are antibiotics indicated for bacterial gastroenteritis?

Answer 12

Not usually

Question 13

Why are antibiotics not usually indicated for bacterial gastroenteritis?

Answer 13

Because the duration of symptoms is not altered, and it may increase the risk of chronic carrier statusq

Question 14

What are the indications for antibiotics in bacterial gastroenteritis?

Answer 14

• High risk of disseminated disease
• Presence of artificial implants, e.g. V-P shunt
• Severe colitis
• Severe systemic illness
• Age <6 months
• Enteric fever
• Cholera
• E. Coli 0157

Question 15

What antibiotics are given if required in bacterial gastroenteritis?

Answer 15

Most organisms are sensitive to ampicillin, co-trimoxazole, or third generation cephalosporins.

Question 16

What antibiotic should be considered if campylobacter is the causative organism?

Answer 16

Erythromycin

Question 17

What antibiotic should be given if C. Diff is the causative organism?

Answer 17

Oral vancomycin or metronidazole

Question 18

What are the potential complications of bacterial gastroenteritis?

Answer 18

• Bacteraemia
• Secondary infections
• Reiter’s syndrome
• Haemolytic-uraemic syndrome
• Guillian-Barre syndrome
• Reactive arthropathy
• Haemorrhagic colitis

Question 19

What secondary infections can result from bacterial gastroenteritis?

Answer 19

• Pneumonia
• Osteomyelitis
• Meningitis

Question 20

Which bacterial causes of gastroenteritis are associated with Reiter’s syndrome?

Answer 20

• Shigella

- Campylobacter

Question 21

What bacterial causes of gastroenteritis are associated with haemolytic-uraemic syndrome?

Answer 21

• E. coli 0157

- Shigella

Question 22

What bacterial causes of gastroenteritis are associated with Guillian-Barre syndrome?

Answer 22

Campylobacter

Question 23

What bacterial causes of gastroenteritis are associated with reactive arthropathy?

Answer 23

Yersina