Presentation is loading. Please wait.

Presentation is loading. Please wait.

DR RONALDA DE LACY. WHY IS IT DONE? Colour Consistency Frequency Blood Bacteria Viruses Parasites Fungal Pancreatic function Intestinal malabsorption.

Similar presentations


Presentation on theme: "DR RONALDA DE LACY. WHY IS IT DONE? Colour Consistency Frequency Blood Bacteria Viruses Parasites Fungal Pancreatic function Intestinal malabsorption."— Presentation transcript:

1 DR RONALDA DE LACY

2 WHY IS IT DONE? Colour Consistency Frequency Blood Bacteria Viruses Parasites Fungal Pancreatic function Intestinal malabsorption Inflammatory markers

3 STOOL COLOUR

4

5 STOOL CONSISTENCY

6 STOOL FREQUENCY Breastfed infants – stool after every breastfeed - once to twice a week Children on average 1 to 2 stools per day Some children might have a stool every 2 nd day

7 BLOOD FRESH BLOOD Lower GIT bleed- anal fissure - rectal haemorrhoids - polyps - inflammatory bowel disease - infections i.e. Shigella, salmonella - meckels diverticulum - intussception - NEC

8 BLOOD ALTERED BLOOD (MALAENA) Upper GIT bleed- oesophagitis - mallory-weiss tear - gastritis - ulcers–gastric, duodenal, small bowel - vascular malformations - anastomotic sites

9 BACTERIA SHIGELLA Gram-negative rod Nonspore forming, non-motile Four serogroups- S. Dysenteriae (12 serotypes) - S. Flexeneri (6 serotypes) - S. Boydii (18 serotypes) - S. Sonnei (1 serotype) S. Flexeneri most frequently isolated in developing world – 60% of cases S. Sonnei most frequently isolated in developed world – 77% of cases

10 SHIGELLA

11 BACTERIA SALMONELLA Gram-negative rod Nonspore forming, motile Many serotypes

12 SALMONELLA

13 BACTERIA CHOLERA Only infects humans Transmission by faecal contamination of water and food Organism secretes an enterotoxin Results in watery diarrhoea

14 CHOLERA

15 BACTERIA CAMPYLOBACTER Gram-negative rod- comma or S-shaped Transmission is faecal-oral Cattle, chickens and dogs are sources

16 CAMPYLOBACTER LIFECYCLE

17 BACTERIA YERSINIA ENTEROLITICA Gram-negative oval rod Contaminated food Enterocolitis

18 BACTERIA CLOSTRIDIUM DIFFICILE Antibiotic use Fresh stool sample

19 BACTERIA MYCOBACTERIA Tuberculosis Transmission by respiratory droplets Mainly respiratory disease Dissemination can result in intestinal involvement Bovis Transmission by unpasteurised cows milk Intestinal involvement Difficult to culture from stool-need tissue

20 VIRUS ROTAVIRUS RNA virus Most common cause for diarrhoea Vaccine available Diagnosis antigen testing on the stool

21 ROTAVIRUS

22 VIRUS ADENOVIRUS DNA virus 31 antigenic types High swinging fevers Pneumonia Conjunctivitis Diarrhoea Diagnosis – antigen testing on the stool

23 ADENOVIRUS

24 PARASITES ENTEROBIUS VERMICULARIS Pinworm infection Lifecycle confined to humans Eggs recovered from peri-anal area with tape Adult worms may be found in the stool

25 ENTEROBIUS VERMICULARIS

26 ENTEROBIUS VERMICULARIS(PINWORM)

27 PARASITES ASCARIS LUMBRICOIDES Transmission-eating eggs in contaminated soil Diagnosis- oval eggs in the stool or adult worms seen

28 ASCARIS LUMBRICOIDES EGG

29 ASCARIS LUMBRICOIDES LIFECYCLE

30 PARASITES TRICHURIS TRICHURIUM Whipworm infection Transmission-eating eggs in contaminated soil Diagnosis- barrel-shaped eggs in the stool

31 TRICHURIS TRICHIURA EGGS

32 TRICHURIS TRICHURIUM LIFECYCLE

33 PARASITES TAENIA SOLIUM Ingestion of larvae in undercooked pork Diagnosis- proglottids in stool gravid proglottids have 5-10 primary uterine branches TAENIA SAGINATA Ingestion of larvae in undercooked beef Diagnosis- gravid proglottids have primary uterine branches

34 TAENIA EGG

35 TAENIA SAGINATA FOUR SUCKERS NO HOOKS

36 TAENIA SOLIUM FOUR SUCKERS DOUBLE ROW OF HOOKS

37 TAENIA LIFECYCLE

38 PARASITES-PROTOZOA GIARDIA LAMBLIA Flagellated protozoan Waterborne transmission Faecal-oral route Infects the small intestine Difficult to isolate, need minimum of 3 stool specimens Diagnosis- trophozoites or cysts in diarrhoeal stools - trophozoites- pear-shaped, 2 nuclei, 4 pairs of flagella, suction disk

39 GIARDIA LAMBLIA TROPHOZOITE

40 PARASITES-PROTOZOA CRYPTOSPORIDIUM Coccidian protozoa Waterborne transmission Direct person to person contact Immunocompromised patients Diagnosis- oocysts in faecal smears

41 CRYPTOSPORIDIUM OOCYSTS

42 CRYPTOSPORIDIUM OOCYSTS-EM

43

44 PARASITES-PROTOZOA ENTAMOEBA HISTOLYTICA Transmission-faecal-oral route, contaminated food and water Diagnosis- trophozoites in diarrhoeal stools - cysts in formed stools – 4 nuclei

45 ENTAMOEBA HISTOLYTICA CYST

46 PARASITES-PROTOZOA ISOSPORA BELLI Faecal-oral transmission Immunocompromised patients Diagnosis-oocysts in faecal specimen

47 ISOSPORA BELLI OOCYSTS

48

49 FUNGAL CANDIDA ALBICANS Part of normal gut flora Overgrowth in diabetes, immunocompromised patients and prolonged antibiotic use. Diagnosis- oval yeast with a single bud in the stool

50 CANDIDA ALBICANS

51 PANCREATIC FUNCTION Faecal elastase >200ug/g faeces - normal Low in chronic diarrhoea <15ug/g indicates pancreatic insufficiency-cystic fibrosis

52 INTESTINAL MALABSORPTION CARBOHYDRATE MALABSORPTION Faecal reducing substances – positive – osmotic diarrhoea Faecal osmolar gap (FOG) – serum osmolarity- 2x(faecal sodium + potassium concentration) FOG >100 mosm/l – osmotic diarrhoea FOG <100 mosm/l – secretory diarrhoea Need a liquid stool

53 INTESTINAL MALABSORPTION PROTEIN MALABSORPTION Stool alpha 1 anti-trypsin Need a pre-weighed container Clearance rate ml/24hrs

54 INTESTINAL MALABSORPTION FAT MALABSORPTION 3 day faecal fat measurement Histology- free fat Steatocrit-not specific for free fat

55 INFLAMMATORY MARKERS COLPROTECTIN Calcium and zinc binding protein Accounts for 30-40% of neutrophil cytosol Resistant to enzymatic degradation Strongly correlated with 111-indium labelled leucocytes References range- upper limit 2-9yrs – 166ug/g faeces 10-59yrs- 51 ug/g faeces


Download ppt "DR RONALDA DE LACY. WHY IS IT DONE? Colour Consistency Frequency Blood Bacteria Viruses Parasites Fungal Pancreatic function Intestinal malabsorption."

Similar presentations


Ads by Google