Quiz diarrhea ๋
 
Entamoeba histolytica <ul><li>Trophozoite and cystic form </li></ul><ul><li>Invasive produce colonic ulceration </li></ul>...
<ul><li>Rx : paromomycin, iodoquinol, diloxanide furoate </li></ul><ul><li>Severe symptoms:metronidazole750 mg tid x10 day...
 
Enterobius vermicularis <ul><li>Pinworm or seatworm </li></ul><ul><li>Natural host: human </li></ul><ul><li>Noninvasive </...
 
Giardia <ul><li>Backpacker’s diarrhea </li></ul><ul><li>Pt with decreased gastric acid: susceptible to Giardia infection <...
Giardia  <ul><li>Acute infection: stool exam sens>95% </li></ul><ul><li>Chronic infection: ELISA, DFA </li></ul><ul><li>Rx...
 
Ascaris lumbricoides <ul><li>eggs are swallowed   invade intestine mucosa  lungs  the bronchial tree   swallowing to t...
5 micron
20 micron
Coccidial infection <ul><li>Cryptosporidium </li></ul><ul><li>most common cause of chronic diarrhea in AIDS </li></ul><ul>...
Coccidial infection <ul><li>Non invasive </li></ul><ul><li>Mild to profuse watery diarrhea </li></ul><ul><li>Dx:oocysts in...
Cyclospora
Cyclospora cayetamemsis <ul><li>Acute explosive watery diarrhea and abdominal cramps ,subside in 1-3 day </li></ul><ul><li...
 
Strongyloides stercoralis <ul><li>uncomplicated strongyloidiasis: asymptomatic </li></ul><ul><li>Immunocompromise host: Co...
 
Tenia  <ul><li>Intestinal infections with  T. solium  may be asymptomatic </li></ul><ul><li>In cysticercosis: cysticerci c...
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Sep 11 quiz diarrhea

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By Kanjanee Wachirarangsiman, MD

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Sep 11 quiz diarrhea

  1. 1. Quiz diarrhea ๋
  2. 3. Entamoeba histolytica <ul><li>Trophozoite and cystic form </li></ul><ul><li>Invasive produce colonic ulceration </li></ul><ul><li><1% spread outside the intestine :liver ,brain infection, pleural or pericardial effusion </li></ul><ul><li>Complication: GI bleeding, toxic megacolon, intussusception, stricture,perforation </li></ul><ul><li>Stools: blood-streaked mucus </li></ul><ul><li>Ab-based enzyme immunoessay sens and spec 95% </li></ul>
  3. 4. <ul><li>Rx : paromomycin, iodoquinol, diloxanide furoate </li></ul><ul><li>Severe symptoms:metronidazole750 mg tid x10 day </li></ul>
  4. 6. Enterobius vermicularis <ul><li>Pinworm or seatworm </li></ul><ul><li>Natural host: human </li></ul><ul><li>Noninvasive </li></ul><ul><li>Perianal tingling or itching at night </li></ul><ul><li>Cellophane tape test </li></ul><ul><li>Rx empirically all other familial member </li></ul><ul><li>Albendazole 400 mg once,2 nd dose at 2 wk later </li></ul>
  5. 8. Giardia <ul><li>Backpacker’s diarrhea </li></ul><ul><li>Pt with decreased gastric acid: susceptible to Giardia infection </li></ul><ul><li>Proximal bowel,superficial invasion of the mucosa </li></ul><ul><li>Symptoms:from malabsorption </li></ul><ul><li>Abdominal distension, colicky pain, flatulence, frequency explosive diarrhea </li></ul>
  6. 9. Giardia <ul><li>Acute infection: stool exam sens>95% </li></ul><ul><li>Chronic infection: ELISA, DFA </li></ul><ul><li>Rx:metronidazole 250 mg tid x7 day </li></ul>
  7. 11. Ascaris lumbricoides <ul><li>eggs are swallowed  invade intestine mucosa  lungs  the bronchial tree  swallowing to the small intestine </li></ul><ul><li>adult worms in the small intestine: no symptoms </li></ul><ul><li>nonproductive cough ,substernal discomfort,dyspnea,fever,eosinophilia </li></ul><ul><li>Rx:Albendazole (400 mg once), mebendazole (500 mg once), or ivermectin (150–200 g/kg once) </li></ul>
  8. 12. 5 micron
  9. 13. 20 micron
  10. 14. Coccidial infection <ul><li>Cryptosporidium </li></ul><ul><li>most common cause of chronic diarrhea in AIDS </li></ul><ul><li>Isospora belli </li></ul><ul><li>OI in AIDS </li></ul>
  11. 15. Coccidial infection <ul><li>Non invasive </li></ul><ul><li>Mild to profuse watery diarrhea </li></ul><ul><li>Dx:oocysts in stool, acid fast stain ,EISA </li></ul><ul><li>Cryptosporidium 5 micron, Isospora 20 micron </li></ul><ul><li>Cryptosporidium Rx:Self-limited in immunocompetent, AIDS:HAART </li></ul><ul><li>Isosporisis: TMP-SMX </li></ul>
  12. 16. Cyclospora
  13. 17. Cyclospora cayetamemsis <ul><li>Acute explosive watery diarrhea and abdominal cramps ,subside in 1-3 day </li></ul><ul><li>Followed by intermittent mild diarrhea and marked anorexia and fatigue </li></ul><ul><li>Dx: modified acid fast stain 8-10 micron,DDx cryptosporidium </li></ul><ul><li>Rx:TMP-SMX </li></ul>
  14. 19. Strongyloides stercoralis <ul><li>uncomplicated strongyloidiasis: asymptomatic </li></ul><ul><li>Immunocompromise host: Colitis, enteritis, or malabsorption </li></ul><ul><li>In disseminated strongyloidiasis:GI,lungs,CNS , peritoneum, liver, and kidneys </li></ul><ul><li>Gram-negative sepsis, pneumonia, or meningitis may complicate </li></ul><ul><li>Dx: larvae in stool </li></ul><ul><li>Rx:Ivermectin 200 g/kg daily for 2 days, albendazole 400 mg daily for 3 days </li></ul><ul><li>For disseminated strongyloidiasis rx at least 5–7 days or until the parasites are eradicated. </li></ul>
  15. 21. Tenia <ul><li>Intestinal infections with T. solium may be asymptomatic </li></ul><ul><li>In cysticercosis: cysticerci can be found anywhere in the body but are most commonly detected in the brain </li></ul><ul><li>Dx: proglottid in stool </li></ul><ul><li>Rx:A single dose of praziquantel (10 mg/kg) is highly effective </li></ul>
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