Cushing syndrome endocrinology

1. TOPIC : INTESTINAL INFECTIOUS DISEASE
NAME : SAYALI GORAKHNATH KAPURKAR
GROUP :33
SEM : 5TH
SUBMITTED TO : MARAL MA’AM

2. INFECTIOUS DISEASE
• Infectious diseases are disorders that are caused by organisms,
usually microscopic in size, such as bacteria, viruses, fungi, or
parasites that are passed, directly or indirectly, from one person to
another.
• Intestinal disease include:
• Typhoid fever
• Dysentery
• Salmonellosis
• Ref – https://www.mayoclinic.org/diseases-conditions/infectious-
diseases/symptoms-causes/syc-

3. TYPHOID FEVER
• Typhoid fever, also known as typhoid, is a disease caused by
Salmonella serotype Typhi bacteria.
• Typhoid is caused by the bacterium Salmonella enterica
subsp. Enterica serovar
• Typhi growing in the intestines, Peyer’s patches, mesenteric
lymph nodes, spleen, liver, gallbladder, bone marrow and
blood.
Ref. – Robbins textbook page no 56

4. TYPHOID WITH HAEMOPHAGOCYTOSIS
Ref -
https://images.app.goo.gl/QK3ohajffborqkUY6

5. MORPHOLOGY
• A) cerebriform swelling of the Peyer’s patches
and lymphoid follicles of small intestine,
b)necrosis of Peyer’s patches and lymphoid
follicles,
• c)ulceration of Peyer’s patches and lymphoid
follicles,
• d)formation of clean ulcers of small intestine,
Refrence – Robbins textbook page no. 56

6. GROSSLY
• On colonoscopy, typhoid fever-related
gastrointestinal ulcers appear as
• multiple, ovoid, variable-sized punched out
lesions.
• The edges are soft, swollen and irregular
• Intestinal perforation occurs commonly near the
ileo-caecal valve, where the ulcers become deeper
than elsewhere
Ref. – Robbins textbook page 56

7. ETIOLOGY
• It is caused by a bacteria called salmonella typhi.
• Also it can spread by contaminated food or
water/(drink)
• Direct contact with someone who is infected.
• Typhoid fever can be spreaded by so many ways. There
is also a bacteria that can get into your bloodstream.
Ref. – Robbins textbook page no 57

8. INFLAMMATION OF INTESTINE
Ref
:https://my.clevelandclinic.org/health/symptoms/2166
0-inflammation

9. PATHOGENESIS
• Pathogenic mechanisms of viral disease
include :
• implantation of virus at the portal of
entry,
• local replication
• spread to target organs (disease sites)
• spread to sites of shedding of virus into
the environment.
Ref. – Robbins textbook page no 57

10. ULCER OF SMALL INTESTINE
Ref :
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC55720
1/

11. SYMPTOMS
• Fever that starts low and increases daily, possibly reaching as high
as 104.9 °F (40.5 °C)
• Headache,
• weakness and fatigue,
• muscle aches
, sweating, dry cough, loss of appetite, weight loss, stomach pain,
diarrhea or constipation, rash, swollen stomach (enlarged liver or
spleen)
Ref – Robbins textbook page no 57

12. TYPHOID ULCER
Ref :
https://thyroidresearchjournal.biomedcentral.com/articles/10.11
s13044-018-0050-0

13. DIAGNOSIS & TREATMENT
• Diagnosis is made by any blood, bone marrow, or stool cultures and with the
Widal test.
• Typhidot test : it is based on the presence of specific IgM and IgG antibodies.
• Treatment:
• Oral rehydration therapy
• Abtibiotics
• Surgery
• resistance
Ref. – Robbins textbook page no 58

14. PURULENT PERITONITIS
Ref : https://www.ncbi.nlm.nih.gov/books/NBK560735/

15. DESENTRY
• Dysentery results from bacterial, or parasitic
infections. Viruses do not generally cause the
disease. These pathogens typically reach the large
intestine after entering orally, through ingestion of
contaminated food or water, oral contact with
contaminated objects or hands, and so on.
Ref. – modern view of their pathology page no.
131

16. THERE ARE TWO MAIN TYPES OF DYSENTERY:
• Amoebic dysentery (amoebiasis) : parasite Entamoeba histolytica) is
one of the main causes of amoebic dysentery. Other parasites that
cause amoebic dysentery include Balantidium coli and
strongyloidiasis.
• Bacillary dysentery : bacterial infection causes bacillary dysentery.
Some of the most common bacteria that cause bacillary dysentery
include Shigella, Salmonella, Campylobacter and Escherichia coli.
Bacillary dysentery is the most common type of dysentery.
Ref. – modern view of their pathology page no 131

17. MORPHOLOGY
• Local lesions (morphogenesis) :
• a) catarrhal colitis,
• b)fibrinous colitis,
• c) ulcerative colitis
• d)healing of ulcers .
Ref : https://www.histopathology.guru/morphology-of-peptic-ulcer/

18. FIBRINOUS COLITIS
Ref : https://pubmed.ncbi.nlm.nih.gov/4919467/

19. SYMPTOMS
• Diarrhea.
• High fever.
• Nausea and vomiting.
• Weight loss.
• Upset stomach.
• Painful stomach cramps (abdominal pain).
Ref. – modern view of their pathology page no 132

20. FIBRINOUS COLITIS
Ref : https://pubmed.ncbi.nlm.nih.gov/4919467/

21. ETIOLOGY
• Shigella, which leads to shigellosis.
• Salmonella, which causes salmonella.
• Campylobacter, which causes
campylobacteriosis.
• Escherichia coli, which leads to E. Coli
infection.
Ref . – modern view of their pathology page no 132

22. PATHOGENESIS
• Dysentery is caused when the
bacteria escape the epithelial cell
phagolysosome, multiply within
the cytoplasm, and destroy host
cells.
• Shiga toxin causes hemorrhagic
colitis and hemolytic-uremic
syndrome by damaging
endothelial cells in the
microvasculature of the colon and
the glomeruli, respectively.
Ref. – modern view of their pathology page no
133

23. ULCERATIVE COLITIS
Ref : https://www.nhs.uk/conditions/ulcerative-
colitis/#:~:text=Ulcerative%20colitis%20is%20a%20long,can%20bleed%
20produce%20pus.

24. COMPLICATIONS
• Dehydration
• Liver abscess: Amebic dysentery can causeTrusted Source
an abscess in the liver.
• Postinfectious arthritis (PIA): A person may develop PIA as
a complication of Shigella infection.
• Hemolytic uremic syndrome
Ref. – modern view of their pathology page no 134

25. ULCERATIVE COLITIS
Ref : https://my.clevelandclinic.org/health/diseases/10351-
ulcerative-colitis

26. DIAGNOSIS
• Disease characterized by severe diarrhea with passage of mucus and
blood from the bowel.
• Stool test : reddish brown
• Flask shaped ulcer
• Isolation of shigella from feces or rectal swabs provide
bacteriological diagnosi
• Blood is observed in a fresh stool specimen
Ref. – modern view of their pathology page no 134

27. RECTAL ULCERATIVE COLITIS
Refhttps://www.mayoclinic.org/diseases-conditions/ulcerative-
colitis/symptoms-causes/syc-20353326 :

28. TREATMENT
• If the person has diarrhea, they should drink plenty of
fluids to avoid dehydration.
• amebiasis : , it’s important to rid your body of the
parasite. Your healthcare provider will prescribe
metronidazole.
• bacillary dysentery, : treatment may include antibiotics
and IV fluids. In rare cases, you may need a blood
transfusion.
Ref. – modern view of their pathology page no 134

29. FOLLICULAR ULCERATIVE COLITIS
Ref : https://www.webmd.com/skin-problems-and-
treatments/what-is-folliculitis

30. PREVENTION
• Don’t share personal items with other people, including
toothbrushes, drinking glasses and towels.
• Don’t use water unless you’re sure it’s sanitized or sterile .
• Stay away from people who have dysentery.
• Wash all fruits and vegetables with clean running water. Peel them
before eating them.
• Thoroughly cook all food. Ref. – modern view of their pathology page no 135

31. SALMONELLOSIS
• Salmonellosis is a symptomatic infection caused by
bacteria of the Salmonella type.
• it is also a food-borne disease and these are
defined as diseases, usually either infectious or
toxic in nature, caused by agents that enter the
body through the ingestion of food.
Ref. – harsh mohan textbook Page no - 66

32. • There are two species of Salmonella: Salmonella
bongori and Salmonella enterica with
many subspecies. However, subgroups
and serovars within a species may be substantially
different in their ability to cause disease
Ref. – harsh mohan textbook page no 67

33. MORPHOLOGY
• 1)Intestinal type (food poisoning) – acute
gastroenteritis and exicosis.
• 2)Septic type – minimal local lesions (catarrhal
enteritis) and hematogenic dissemination of infection
with formation of absceses of the inner organs.
• 3)Typhoid type – morphology resembling typhoid
fever.
Ref – harsh mohan textbook page no 67

34. CATARRHAL ENTERITIS
Ref : https://www.crohnscolitisfoundation.org/justlikeme/what-
are-crohns-colitis/what-ulcerative-colitis

35. GROSSLY
• The characteristic gross lesions in salmonellosis affected birds
include :
• friable liver with bronze discoloration,
• white focal necrosis on liver,
• congested, haemorrhagic and discolored egg follicles with stalk
formation,
• haemorrhagic to catarrhal enteritis,
• severely congested pneumonic lungs.
Ref. – harsh mohan textbook page no 68

36. ETIOLOGY
• Contaminated food, often having no unusual look or
smell.
• Excretions from either sick or infected but apparently
clinically healthy people and animals.
• Unhygienically thawed poultry (the meltwater contains
many bacteria).
• Polluted surface water and standing water (such as in
shower hoses or unused water dispensers)
Ref – harsh mohan textbook page no 68

37. SYMPTOMS
• Diarrhea
• Stomach (abdominal) cramps
• Fever
• Nausea
• Vomiting
• Chills
• Headache
• Blood in the stool
Ref : Robinson page 189

38. INFLAMMATION OF SMALL INTESTINE
Ref : https://www.spine-health.com/conditions/sacroiliac-j
dysfunction/all-about-sacroiliitis

39. PATHOGENESIS
• Pathogenic salmonellae ingested in
food survive passage through the
gastric acid barrier and invade the
mucosa of the small and large intestine
and produce toxins.
• Invasion of epithelial cells stimulates
the release of proinflammatory
cytokines which induce an
inflammatory reaction.
Ref . – harsh mohan textbook page no 68

40. PATHOLOGY OF SALMONELLA
Ref :
https://www.tandfonline.com/doi/full/10.1080/21553769.2015.10512
43

41. DIAGNOSIS
• Salmonella infection is diagnosed when a laboratory test
detects Salmonella bacteria in a person’s poop (stool),
• body tissue,
• fluids.
• If your health care provider suspects that you have a
salmonella infection in your bloodstream, testing a sample
of your blood for the bacteria may be needed.
Ref . – harsh mohan textbook page no 69

42. PERFORATION OF CAECUM
Ref :
https://www.sciencedirect.com/science/article/abs/pii/00029610
52900810

43. TREATMENT
• Treatment of salmonella infections are more successful if
salmonella species is first determined.
• Once the particular species of salmonella has been
identified, the appropriate antibiotic can be administered.
• The frequently found Salmonella strains are sensitive to
many commonly available antibiotics.
Ref. – harsh mohan textbook page no 69

44. NECROSIS OF CAECUM
Ref : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379799/

45. PREVENTION
• Wash your hands.
• Keep your food preparation areas clean.
• Avoid unpasteurized foods.
• Cook and store your food at the appropriate
temperatures.
• Be careful when handling animals.
• Use caution when swimming.
Ref. – harsh mohan textbook page no 69

46. REFERENCE
• https://www.britannica.com/science/dysentery
• https://www.who.int/news-room/fact-
sheets/detail/typhoid#:~:text=Typhoid%20fever%20
is%20a%20life,and%20spread%20into%20the%20bl
oodstream.
• Robbins basic pathology( page no. 56)