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Diarrhea A child with diarrhea
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Objectives: You students will be able to
get a detailed history and associated symptoms. get the DD depending on physical finding and proper diagnostic approach. evaluate and manage a child with diarrhea.
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Defenses mechanisms Gastric acidity GI peristalsis Normal flora
Immune defenses
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Pathogenesis of diarrhea
Villous damage Enterotoxin Cytotoxin invasion
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Causes of gastroenteritis
Viruses Bacteria parasites
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Rotavirus gastroenteritis
Infants & children Destruction of brush border Usually mild to moderate diarrhea If severe: dehydration, shock Diagnosis: exclude other causes Treatment: fluids PO/IV
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Salmonella gastroenteritis
Cause: salmonella enteritides Source: GIT of animals Presentation: abdominal pain, nausea, vomiting ,diarrhea +/- fever Diagnosis: stool microscopy & culture Treatment: fluids PO/IV Antibiotics: only for severe cases or impaired immunity
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Shigellosis Transmission: contaminated food or drink
Causes invasive colitis Presentation: abdominal pain, diarrhea, fever+ dysentery Diagnosis: stool microscopy & culture Treatment: fluids – antibiotics
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Campylobacter gastroenteritis
Source: GIT of animals Causes invasive enterocolitis Transmission: contaminated food or drink Presentation: fever, malaise, abd.pain diarrhea+ blood Diagnosis: stool microscopy & culture Treatment: fluids -- antibiotics
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E.Coli gastroenteritis
Normal flora of GIT Pathogenic mechanisms: > enterotoxigenic > enteropathogenic > enteroinvasive Diagnosis: by exclusion Treatment: fluids
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Cholera Transmission:contaminated food or drink
Pathogenesis: enterotoxin Presentation: asymptomatic – mild if severe: dehydration &shock Diagnosis: stool culture Treatment: fluids – antibiotic
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Amebiasis Transmission : by cysts Causes invasive colitis
Presentation: asymptomatic acute dysentery chronic amebiasis Complications: liver abscess Diagnosis: stool microscopy , serology Treatment: metronidazole
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Giardiasis Transmission: Colonize upper small intestine
Presentation: asymptomatic – mild to moderate :abdominal. pain , flatulence May become chronic Diagnosis: stool microscopy Treatment: metronidazole
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Food poisoning Vomiting within 6 hrs of eating
Abd pain , diarrhea after 8 – 16 hrs Abd. Pain , diarrhea after 16 – 48 hrs Abd. Pain, diarrhea , fever hrs
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