Bacterial enterocolitis
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BACTERIAL enterocolitis. Ingestion of bacterial toxins Staph Vibrio Clostridium Ingestion of bacteria which produce toxins Montezuma’s revenge (traveller’s diarrhea), E.coli Infection by enteroinvasive bacteria Enteroinvasive E. coli (EIEC) Shigella Clostridium difficile. E. coli.

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BACTERIAL enterocolitis

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Bacterial enterocolitis

BACTERIAL enterocolitis

  • Ingestion of bacterial toxins

    • Staph

    • Vibrio

    • Clostridium

  • Ingestion of bacteria which produce toxins

    • Montezuma’s revenge (traveller’s diarrhea), E.coli

  • Infection by enteroinvasive bacteria

    • Enteroinvasive E. coli (EIEC)

    • Shigella

    • Clostridium difficile


E coli

E. coli

  • Toxin, invasion, many subtypes

  • Food, water, person-to-person

  • Usually watery, some hemorrhagic

  • INFANTS often, in epidemics


Salmonella

SALMONELLA

Food, not hemorrhagic

SHIGELLA

(person-to-person, invasive, i.e., often hemorrhagic)


Camplyobacter

CAMPLYOBACTER

  • Toxins, Invasion

  • Food spread


Yersinia enterocolitica

YERSINIA (enterocolitica)

  • Food

  • Invasion

  • LYMPHOID REACTION


Vibrio cholerae

VIBRIO cholerae

  • Water, fish, person-to-person

  • Cholera epidemics

  • NO invasion (watery)

  • ENTEROTOXIN


Clostridium difficile

CLOSTRIDIUM DIFFICILE

  • CYTOTOXIN (lab test readily available)

  • NOSOCOMIAL

  • PSEUDOMEMBRANOUS (ANTIBIOTIC ASSOCIATED) COLITIS


Malabsorption

MALABSORPTION

  • INTRALUMINAL

  • BRUSH BORDER (microvilli)

  • (TRANS)EPITHELIAL

  • OTHER

    • REDUCED MUCOSAL AREA: Celiac, Crohns

    • LYMPHATIC OBSTRUCTION: Lymphoma, TB

    • INFECTION

    • IATROGENIC: Surgical


Intraluminal

INTRALUMINAL

  • PANCREATIC

  • DEFECTIVE/REDUCED BILE

  • BACTERIAL OVERGROWTH


Brush border

BRUSH BORDER

  • DISACCHARIDASE DEFICIENCY

  • BRUSH BORDER DAMAGE, e.g., by bacteria


Trans epithelial

(Trans)EPITHELIAL

  • ABETALIPOPROTEINEMIA

  • BILE ACID TRANSPORTATION DEFECTS


Celiac disease

CELIAC DISEASE

  • Also called SPRUE

  • Also called NON-tropical SPRUE

  • Also called GLUTEN-SENSITIVE ENTEROPATHY

    • Sensitivity to GLUTEN, a wheat protein, gliadin

    • Immobilizes T-cells

    • Also in oat, barley, rye

    • Progressive mucosal “atrophy”, i.e. villous flattening

    • Relieved by gluten withdrawal


Celiac disease1

CELIAC DISEASE


Tropical sprue

“TROPICAL” SPRUE

  • Epidemic forms

  • NOT related to gluten, cause UN-known

  • RECOVERY with antibiotics


Whipple s disease

WHIPPLE’s DISEASE

  • DISTENDED MACROPHAGES in the LAMINA PROPRIA

  • PAS positive

  • ROD SHAPED BACILLI


Whipple s disease1

WHIPPLE’s DISEASE


Disaccharidase deficiency

DISACCHARIDASE DEFICIENCY

  • LACTASE by far MOST COMMON

  • ACQUIRED, NOT CONGENITAL

  • LACTOSE GLUCOSE + GALACTOSE

  • LACTOSE (fermented)XXXXXXXXX

  • OSMOTIC DIARRHEA


Abetalipoproteinemia

ABETALIPOPROTEINEMIA

  • Autosomal recessive

  • Rare

  • Inability to make chylomicrons from FFAs and MONOGLYCERIDES

  • Infant failure to thrive, diarrhea, steatorrhea


Angiodysplasia

ANGIODYSPLASIA

  • NOT really “dysplasia”

  • NOT neoplastic

  • TWISTED, DILATED SUBMUCOSAL VESSELS, can rupture!

  • Common X-ray finding


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