Gastrointestinal Tract Diseases And Intoxications

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Disease produced by a toxin

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intoxication

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Two of the most common diseases of the GI tract

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gastroenteritis
dysentary

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inflammation of the stomach and intestinal lining

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gastroenteriis

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watery diarrhea with blood, mucus, pain, and fever

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dysentery

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Characteristics: gram (-) rod, human to human spread, often through food
Bacteria: Salmonella typhi
S/S: presents with intestinal ulcerations and bloody stools, rose spots, stepladder fever

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typhoid fever

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Skin hemorrhages associated with typhoid fever

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rose spots

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Characteristics: curved gram (-) rod, choeragen
Bacteria: vibrio cholerae
S/S: rice water stool, massive loss of electrolytes (up to 20 liters/day)
Reservoirs: humans, fresh H2O
TX: measure fluid lost and replace it with electrolyte solution
-7 pandemics since 1800

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cholera

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Characteristics: gram (-) rod, lactose negative
Bacteria: Salmonella
S/S: less severe diarrhea than typhoid fever, gastroenteritis
Transmission: humans, livestock, and reptiles (especially turtles)
-2,400 serotypes of Salmonella cause it instead of typhoid fever
-raw eggs, poultry, raw milk and mayo.

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Salmonellosis

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transmission from an animal to a human

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zoonosis

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Characteristics: gram (-) rod, carried by all mammals, coliform, endotoxin, lipid A
Bacteria: Escherichia coli
Also causes: cystitis, bactiuria, and UTIs

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Traveler's diarrhea

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How is e. coli identified?

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by its ability to ferment lactose on an EMB agar plate which produces dark colonies

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The five Fs of coliform transmission

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feces, flies, fingers, food, and fomites

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Particularly virulent strain of E. coli that causes bloody diarrhea, kidney failure, coma and death; abt ineffective; fecal oral transmission

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0157:H7

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Characteristics: short helical rods, microaerophilic, polar single flagellum
Bacteria: Campylobacter jejuni
S/S: nausea, diarrhea and dysentery in 1/2 of all cases
TX: mild form resolves, dysentery tx=erythromycin
Sources: poultry (most common), milk, h2o
-2 million cases/year in US

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campylobacteriosis

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Characteristics: short helical rods, microaerophilic, gram (-) rod
Bacteria: Helicobacter pylori
-Associated with 90% of ulcers and stomach cancer
-produces urease which releases ammonia that damages stomach lining

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Gastritis

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Characteristics: gram (-) rod, nonmotile
Bacteria: Shigella dysenteriae
S/S: raspberry jam stool c sheets of pus

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Bacillary dysentery

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Characteristics: gram (+) rod, spore former, anaerobe
Bacteria: Clostridium botulinum
S/S first dizziness, blurred vision, nausea, abd pain, then paralysis c resp paralysis most common cause of death
- 1 oz is enough to kill population of US
-absorbed into blood stream, acts on nerves
-linked to SIDS

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Botulism

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Organism related to botulism that can cause food poisoning, particularly associated with rice

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bacillus cereus

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Characteristics: gram (+), staph, short incubation time ( 4 hrs)
Bacteria: strains of staph (endotoxins)
TX: fluid replacement in severe cases (5%), no ABT as stomach acid kills the org but the toxins remain
-toxin is resistant to stomach acid, boiling, or freezing

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Food poisoning (staph)

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Characteristics: gram (+) rod, spore former, anaerobe entertoxin
Bacteria: C. perfringens
S/S primarily diarrhea and abd cramps, appear within 24 hrs
Incubation time: 7-15 hrs

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Food poisoning (c. perfingens

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Characteristics: small gram (-) coccobacillus, slow growing
Bacteria: Brucella
S/S: anorexia, abd pain, diarrhea and nausea; high variation of s/s
-common cause of abortion in cows, sheep, swine and goats
-most common transmission=milk
-Incubation is 2-4 weeks

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brucelosis

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What is EMB agar used for?

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to cx coliforms to trace occurrence of fecal contamination in water and food sources

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How do people get botulism

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by eating can foods that have not been heated properly to kill spores

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Characteristics: naked, icosahedrall virion, RNA
S/S: jaundice is hallmark, dark urine, clay gray stool, n/v, stomach pain, fever
Incubation: 2-4 weeks
Transmission: fecal-oral, uncooked shellfish
-Vaccine available sinc 1996

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Hepatitis A (HAV) aka infectious hepatitis

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A partial breakdown product of hemoglobin, causes jaundice in HAV

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bilirubin

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How is HAV diagnosed?

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S/S and detection of liver enzyme leakage into the bloodstream caused by liver destruction

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The only hepatitis virus that is not an RNA virus

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Hep B

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Characteristics: naked, icosahedral virion, RNA, enterovirus
-can cause aseptic meingitis, herpangina, pleurodynia an myocarditis

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Coxsackie virus

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Strain of Coxsackie virus that is linked to DM, induces autoimmune response that destroys the insulin-secreting cells of the pancreas

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B4

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Characteristics: naked, icosahedral virion, RNA, enterovirus
-can cause gastroenteritis, resp infections and meningitis

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echovirus

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Characteristics: motility via pseudopods
Protozoan: entamoeba histolyitca (most common cause)
S/S: bloody stool c little diarrhea
Transmission: fecally contaminated food or H20
-digest intestinal wall to form uclers
-can be lethal if they travel via blood stream to organ systems

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Amoebiasis

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Characteristics: nonmotile, large oocysts initiate infection
Protozoan: Cyclospora cayetanensis
S/S: watery diarrhea, cramps and vomiting that persist for a month or more
-Common in imported berries

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Cyclosporiasis

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Characteristics: motility via flagella, most common infections protozoan in US
Protozoan: Giardia lamblia
S/S: cramps, nausea, diahrrea, odiferous flatulence
Transmission: contaminated H20; resistant to chlorine
-attach to intestinal villi
-common in hikers; smiley face

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Giardiasis

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Characteristics: nonmotile, small oocysts are infections form
Protozoan: Cyptosporidium parvum
S/S: diarrhea
-invade epithelial cells of intestinal tract
Carriers: dogs, cattle, pigs

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Cryptosporidiosis

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Characteristics: motility by cilia, large 70x100 microns, single celled
Protozoan: Balantidium coli
S/S: nausea, profuse diarrhea and wt loss
Transmission: undercooked food, especially pork; H2O
-Rare in US
Only major human disease caused by ciliates

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balantidiasis

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platyhelminths; hermaphoditic

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flatworms

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aschelminths

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round worms

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Flat, leaf shaped single-celled parasites with complex life cycles with egg stages and larval form

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flukes

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larval form grown in what type of host?

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intermediate host

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adult form of flukes grow in what kind of host?

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definitive host

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Characteristics: motility via cercaria (powerful tails), multicellular c primative nervous and circulatory systems
Schistosome masoni, S. japonicum and S. haemotobium
Intermediate hosts: snails
S/S: liver damage, bloody urine, painful urination
Definitive hosts: humans
Transmission: directly penetrate human skin in contaminated H20
-mate in the human liver

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Schistosomiasis

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motile forms Schistosoma hatch into that swim until they find a snail to be the intermediate host; excreted from human through urine/feces

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miracidia

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A type of dermatitis caused by certain species of Cecaria; stay at site of infection; intermediate host: bird or other animal; northern lakes of US

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swimmer's itch

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Characteristics: flatworm with many segmente proglottids, nonmotile
Taenia saginata (beef)
T. solium (pork)
Transmission: undercooked meat
S/S: minimal, minor diarrhea
-attach to lining of small intestines

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Tape worm

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Head of the tapeworm

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solex

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segments of the tape worm; essentially a uterus

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proglottid

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Helminths that live in all soils and waters and infect every kind of plant and animal known

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Roundworm aka nematodes

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Characteristics: muscular body, roundworm
Enterobius vermicularis
S/S: itching, diarrhea
-most prevalent helminth in children
-diagnosed with cellophane tape pressed against anal area

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Pinworm

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Characteristics: whip-like, muscular roundworm
Trichuris trichiura
Transmission: contaminated food/h2o
-attaches to junction of small and large intestines; may cause anemia

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whipworm

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Characteristics: roundworm, so muscular they damage intestinal tract
Ascaris lumbricoides
-infects 30% of world population, 2% US
-grows 12" in length; female produces 200,000 eggs/day

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Ascariasis

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Characteristics: roundworm, forms painful/damaging cysts in brain/muscles
Trichinella spiralis
S/S: n/v, abd pain, constipation
Transmission: undercooked pork

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Trichinosis

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Characteristics: Roundworm, larvae have hooks that attach to bare feet
Ancylostoma duodenale, Necator americanus
-attach to intestines, cause anemia by sucking blood
-attach to feet, penetrate bloodstream, pass to lungs then coughed up and swallowed to GI tract

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hookworms