SIGNS OF DEHYDRATION
- thirst,
- dry mouth,
- decreased axillary sweat,
- decreased urine output,
- slight weight loss
Mild dehydration
SIGNS OF DEHYDRATION
- orthostatic fall in blood pressure,
- skin tenting,
- sunken eyes (or, in infants, a sunken fontanelle).
Moderate dehydration
SIGNS OF DEHYDRATION: Severe dehydration
- lethargy,
- obtundation,
- feeble pulse,
- hypotension,
- frank shock.
- is the most common travel-related infectious illness.
- time of onset is usually 3 days to 2 weeks
- generally self-limited, lasting |-5 days.
TRAVELER’S DIARRHEA
The most common isolates from persons with the classic
secretory traveler’s diarrhea syndrome.
Enterotoxigenic and Enteroaggregative strains of E. coli
are important settings for outbreaks of enteric infections
- Day-care centers,
- schools
- residential facilities,
- cruise ships
the most common etiologic agent associated with outbreaks of acute gastroenteritis.
Norovirus
has been identified as a cause of antibiotic-associated
hemorrhagic colitis.
Klebsiella oxytoca
Has been associated with outbreaks of diarrhea in nurseries
for newborns
Enteropathogenic E. coli
Causes significant diarrheal illness in elderly patients in
chronic care institutions. The use of Antibacterials alters the
normal colonic flora allowing multiplication of this bacteria.
C. difficile
most morbidity and mortality from enteric pathogens involves children
<5 years of age
high risk of invasive enteropathies, including salmonellosis, listeriosis, and cryptosporidiosis.
Defects in cell-mediated immunity (AIDS)
particular risk of C. difficile colitis and giardiasis.
Hypogammaglobulinemia
are more likely to develop C. difficile infection as a result of chemotherapy and frequent hospitalizations.
Patients with cancer
- stool examination indicate a noninflammatory etiology
- evidence of a common-source outbreak
- ingestion of specific foods
- the time of onset of diarrhea after a meal
BACTERIAL FOOD POISONING
Bacterial Food Poisoning: Sources of Food
1-6 hrs
- Staphylococcus aureus
- Bacillus cereus
- Ham,
- poultry,
- potato or egg salad,
- mayonnaise,
- cream pastries
- Fried rice
Bacterial Food Poisoning: Sources of Food
8-16hr (vomiting rare)
- Clostridium perfringens
- B. cereus
- Beef,
- poultry,
- legumes,
- gravies
- Meats,
- vegetables,
- dried beans,
- cereals
can produce either a syndrome with a short incubation period, mediated by a staphylococcal type of enterotoxin.
B. cereus the emetic form
longer incubation period (8—I6 h), caused by an
enterotoxin resembling F. cofi LT, in which diarrhea and abdominal cramps are characteristic but vomiting is uncommon.
B. cereus the diarrheal form
- longer incubation period (8—14 h)
- inadequately cooked meat, poultry, or legumes
- moderately severe abdominal cramps and diarrhea; vomiting is rare, as is fever.
Clostridium perfringens
NONBACTERIAL AGENTS OF FOOD POISONING
- Capsaicin is found in hot peppers
- Variety of toxins found in fish and shellfish
LABORATORY EVALUATION
Stool culture on selective media such as thiosulfate—citrate—bile salts-sucrose (TCBS) or tellurite-taurocholate—gelatin (TTG) agar:
CHOLERA
LABORATORY EVALUATION
Latex agglutination test
ROTAVIRUS
LABORATORY EVALUATION
RT-PCR and specific antigen enzyme immunoassays
NOROVIRUS
