ACUTE INFECTIOUS DIARRHEA       :BY       DR.SATTI MOH’D SALEH       INFECTIOUS DISEASE        PHYSICIAN       MEDICAL DI...
MECHANISM OF DISEASE                   OSMOTIC LOAD.     1               INTESTINAL SECRETION. 2       MECHANISM OF DISEAS...
OSMOTIC DIARRHEANON ABSOBABLE SUBSTANCE (.(PURGATIVE(MAL ABSORTION (GLUCOSE SPECIFIC MALABSORTION DEFECT (.(DISACHARIDASE
SECRETORY DIARRHEAENTEROTOXIN (HORMONES (VIP (BILE SALTS (ILEAL VESECTION (FATTY ACIDS (ILEAL VESECTION (LAXATIVES (DS...
INFLAMATORY DIARRHEA
ABNORMAL MOTILITY   DM,VAGOTOMY,HYPERTHYROIDISM          MOTILITYALTEREDDM,VAGOTOMY,HYPERTHYROIDISM
ACUTE INFECTIOUSDIARRHEA:DEFINITIONAlteration of normal physiological function GIT.by ingested microorganisms or their pro...
HOST DEFENSE    Host defenses1- Gastric Acidity                      Gastric Acidity- 1   2- Bowel Motility              ...
CAUSES    CAUSES OF ACUTE INFECTIOUS    DIARRHEAWATERY DIARRHEA         WATERY DIARRHEA-B. CEREUS                    B. CE...
DYSENTERYSHIGELLA -SALMONELLA -CAMPYLOBACTER -EIEC -EHEC -.YERSENIA ENT -VIBRIO PARAHAEMOLYTICUS -CLOSTRIDIUM DEFICILE -
Selected notifiable diseases by region Jul - Sept 2011Madina KSA
SYMTOMS & SIGNSTOXIGENIC           INFLAMMATORY                VIRALNo systemic upset   Systemic upsetAbdminal      System...
APROACH TOwith diarrhea Approach to pt PATIENTS                     ( entrotoxin ( a febrile- 1     potentially invading(...
entrotoxin ( a febrile ) - 12 – potentiallyinvading( Fever + blood ordysentery )3- completely invading ( fever+ bactreamia...
DIARRHEA CLINICSPRIMARY CARE CENTER-SEASONAL CENTER-HOSPITALS-EACH CLINIC-DoctorNurseHealth supervisorNecessary requiremen...
OUT PATIENT MANAGEMENT                  FOR MILD DIARRHEA                             SAUDI -                         RESI...
HOSPITALMANAGEMENTSevere Cases     1.Positive Cases    2.Vibrio -Others -Suspected Cases. 3with no proper address
HAJ                  NON HAJ:Name              SURVEY SHEET OF HOSPITALIZED INFECTIOUS DIARRHEA CASES IN               .ME...
:Laboratory TestsBlood   CBC        Hb            PCVRBSUREACREATININEELECTROLYTESSTOOL    GENERAL        BLOODMUCUSWBCOVA...
ANNUAL REPORT OF 2011          Jul                               septTYPHOID AND PARATHYROID = 57.K.S.A                   ...
TREATMENT OF MOST COMMON.GASTROINTESTINAL PATHOGENSS. aureus                Hydration              Self limitedB. cereus  ...
‫حال ت الهسهال منطقة المدينة المنورة‬‫1341 --- 2341 حتى شعبان‬
‫حال ت الهسهال منطقة المدينة‬‫المنورة‬‫2341 حتى شعبان‬ ‫6747‬                              ‫312‬
MANAGEMENT        MANAGEMENT OF INFECTIOUS        DIARRHEA1.   REHYDRATION                                                ...
PREVENTION.PROVISION OF SAFE WATER.    1           1..PERSONAL HYGIENE.    2     2..AVOID UNDERCOOKED FOOD.         3     ...
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Acute Infectious Diarrhea

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Lecture By Dr.Satti Moh'd Saleh
Medical Director

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Acute Infectious Diarrhea

  1. 1. ACUTE INFECTIOUS DIARRHEA :BY DR.SATTI MOH’D SALEH INFECTIOUS DISEASE  PHYSICIAN MEDICAL DIRECTOR  MEEQAT GENERAL HOSPITAL  CBAHI INFECTION CONTROL 
  2. 2. MECHANISM OF DISEASE OSMOTIC LOAD. 1 INTESTINAL SECRETION. 2 MECHANISM OF DISEASE1. DISEASE INTESTINAL MALABSORPTION. 3 OSMOTIC LOAD 2. INTESTINAL SECRETION MOTILITY.4 ALTERED INTESTINAL 3. INTESTINAL MALABSORPTION 4.ALTERED INTESTINAL MOTILITY
  3. 3. OSMOTIC DIARRHEANON ABSOBABLE SUBSTANCE (.(PURGATIVE(MAL ABSORTION (GLUCOSE SPECIFIC MALABSORTION DEFECT (.(DISACHARIDASE
  4. 4. SECRETORY DIARRHEAENTEROTOXIN (HORMONES (VIP (BILE SALTS (ILEAL VESECTION (FATTY ACIDS (ILEAL VESECTION (LAXATIVES (DSS 
  5. 5. INFLAMATORY DIARRHEA
  6. 6. ABNORMAL MOTILITY DM,VAGOTOMY,HYPERTHYROIDISM  MOTILITYALTEREDDM,VAGOTOMY,HYPERTHYROIDISM
  7. 7. ACUTE INFECTIOUSDIARRHEA:DEFINITIONAlteration of normal physiological function GIT.by ingested microorganisms or their products.Toxigenics organisms - - secretion + absorption-Rota Norwalk, otherinal illness - - infection of-.Entrocytes and loss of brush border enzymesInvasive pathogens - - infalm, Int. secretion altered-.motility
  8. 8. HOST DEFENSE Host defenses1- Gastric Acidity Gastric Acidity- 1 2- Bowel Motility Bowel Motility- 2 3- Colonic Flora Colonic Flora- 3 4- Local anti-body Local anti-body- 4 
  9. 9. CAUSES CAUSES OF ACUTE INFECTIOUS DIARRHEAWATERY DIARRHEA WATERY DIARRHEA-B. CEREUS B. CEREUS -- STAPHYLOCOCCUS STAPHYLOCOCCUS -- VIBRIO VIBRIO -- ETEC ETEC -- EPEC -- SALMONELLA SPP. EPEC- CAMPYLOBACTER .SALMONELLA SPP - CAMPYLOBACTER- CLOSTRIDIUM PERFRINGENS - CLOSTRIDIUM PERFRINGENS- CLOSTRIDIUM DEFFICILE - CLOSTRIDIUM DEFFICILE -
  10. 10. DYSENTERYSHIGELLA -SALMONELLA -CAMPYLOBACTER -EIEC -EHEC -.YERSENIA ENT -VIBRIO PARAHAEMOLYTICUS -CLOSTRIDIUM DEFICILE -
  11. 11. Selected notifiable diseases by region Jul - Sept 2011Madina KSA
  12. 12. SYMTOMS & SIGNSTOXIGENIC INFLAMMATORY VIRALNo systemic upset Systemic upsetAbdminal Systemic upsetSmall number pain, tenesmus, fever . URTILarge volume Stool Fever nauseaStool no RBCs no Large number Frequent Myalgialeukocytes. Small volume blood -stain Stool mucus, pus cells Voluminous, watery Mechanism Mechanism Invasion of enterocytes Osmatic or secretory leading to mucosal cell death and inflammatory response
  13. 13. APROACH TOwith diarrhea Approach to pt PATIENTS ( entrotoxin ( a febrile- 1  potentially invading( Fever + blood or – 2  ( dysentery completely invading ( fever + bactreamia- 3  Diarrhea with GI bleeding- 4  Investigation Rectal swab, stool general , Stool c/s , toxin- assay ,elisa, PCR
  14. 14. entrotoxin ( a febrile ) - 12 – potentiallyinvading( Fever + blood ordysentery )3- completely invading ( fever+ bactreamia4- Diarrhea with GI bleedingInvestigation- Rectal swab, stool general ,Stool c/s , toxin assay ,elisa, PCR
  15. 15. DIARRHEA CLINICSPRIMARY CARE CENTER-SEASONAL CENTER-HOSPITALS-EACH CLINIC-DoctorNurseHealth supervisorNecessary requirementsSupervision -Regional Infection control Committee + Preventive -.Medicine Dept
  16. 16. OUT PATIENT MANAGEMENT FOR MILD DIARRHEA SAUDI - RESIDENTS - HAJI WITH PROPER EASILY TRACED - ADDRESS
  17. 17. HOSPITALMANAGEMENTSevere Cases 1.Positive Cases 2.Vibrio -Others -Suspected Cases. 3with no proper address
  18. 18. HAJ NON HAJ:Name SURVEY SHEET OF HOSPITALIZED INFECTIOUS DIARRHEA CASES IN .MEDINA MUNAWARAH DURING HAJ:Age Years Sex: M/F Nationality:History ofFever Nausea VomitingTenesmus Headache Colic( Mayalgia Other (specify:StoolsFrequent >6/day Volume Large Actual amount >1/2 literday small >1/2 liter/6 <Blood Mucus Consistency FormedSemi formedWatery(Other( specifyContacts: One person involvedGroup with common food source:Examination.Temp. Pulse BP RespDehydration Mild Level of consciousness DrowsyModerate SemiconsciousSevere Comatosed
  19. 19. :Laboratory TestsBlood CBC Hb PCVRBSUREACREATININEELECTROLYTESSTOOL GENERAL BLOODMUCUSWBCOVA / CYST AMOEBA / GIARDIA(OTHER( SPECIFYCULTURE RECTAL SWAB STOOL CULTURE BLOOD CULTUREROTA VIRUS Norwalk AGENT: MANAGEMENT & COMMENTS
  20. 20. ANNUAL REPORT OF 2011 Jul septTYPHOID AND PARATHYROID = 57.K.S.A 2011SALMONELLA = 390CASESHIGELLA =7.‫ة‬ )CHOLERA = 0
  21. 21. TREATMENT OF MOST COMMON.GASTROINTESTINAL PATHOGENSS. aureus Hydration Self limitedB. cereus Hydration Self limitedC. perfringeus Hydration Self limitedV.cholrae Tetrcycline’s Ampicilin & TMP-SMXSo effectiveSalmonella TMP-SMX AmpicilinShigella TMP-SMX Quinolon,Yersinia TMP-SMX Tetracyclines.minoglycosides in severe casesCampylobacter Erythromycin QuinolonesE. coli Hydration Self limitingv. parahaemolyticus Tetracyclines TMP-SMXRotavirus Hydration No specific treatmentNorwalk virus Hydration No specific treatmentTNIDAZOLE Me tronidazole G. lambiaE. histolytica Me tronidazole
  22. 22. ‫حال ت الهسهال منطقة المدينة المنورة‬‫1341 --- 2341 حتى شعبان‬
  23. 23. ‫حال ت الهسهال منطقة المدينة‬‫المنورة‬‫2341 حتى شعبان‬ ‫6747‬ ‫312‬
  24. 24. MANAGEMENT MANAGEMENT OF INFECTIOUS DIARRHEA1. REHYDRATION REHYDRATION 1. ORS ORS IV IV FLUIDS FLUIDS SHOCK SHOCK SEVERE VOMITING SEVERE VOMITING DEPRESSED MENTAL STATE DEPRESSED MENTAL2. INDICATIONS FOR ANTIMICROBIALS STATE a( Parasitic infections E. histililytica INDICATIONS FOR ANTIMICROBIALS. 2 a) Parasitic infections G. lambia E. histililytica Other parasitic infection G. lambia b(. V.cholerae Cases Other parasitic infection Carriers b). V.cholerae Cases discharge after 3 consecutive negative post treatment samples c(. Carriers Salmonella Infants discharge after 3 consecutive negative post treatment samples c). Salmonella Infants
  25. 25. PREVENTION.PROVISION OF SAFE WATER. 1 1..PERSONAL HYGIENE. 2 2..AVOID UNDERCOOKED FOOD. 3 3..HEALTH INSPECTION. 4 4..HEALTH EDUCATION. 5 5..ISOLATION & TREATMENT OF CARRIERS. 6 6..SCREENING OF FOOD HANDLERS. 7 7.
  26. 26. Thank you 
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