This document summarizes information on acute intestinal infections including dysentery, salmonellosis, and Escherichia coli infection. It describes the etiology, epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of these conditions. The main points are:
- Dysentery is caused by Shigella bacteria and causes bloody diarrhea and abdominal pain. Salmonellosis is caused by Salmonella bacteria and can cause diarrhea, fever, or systemic infection. E. coli infection is most common in babies and causes watery diarrhea.
- These infections are usually spread through contaminated food or water. Symptoms range from mild diarrhea to severe dehydration. Diagnosis involves bacterial culture of stool samples.
Foodborne diseases, also called foodborne illness, is an illness caused by eating contaminated food. Infectious organisms including; bacteria, viruses and parasites or their toxins are the most common causes of food poisoning
Foodborne diseases, also called foodborne illness, is an illness caused by eating contaminated food. Infectious organisms including; bacteria, viruses and parasites or their toxins are the most common causes of food poisoning
Most medically important family of non–spore-forming gram-negative rods.
Most species are normal flora of the GI tract. Salmonella, Shigella, and Yersinia are not normal GI flora.
Major cause of nosocomial infections
Diseases include UTIs, gastroenteritis, septicemia, food poisoning, wound infections, peritonitis, pneumonia, and meningitis
The family exhibits four serological characteristics:
O (somatic) antigen-A cell wall antigen-LPS (heat stable), Used for serological grouping of Salmonella & Shigella.
K (envelope) antigen-Capsular antigen (heat labile)
H (flagellar) antigen-Flagellar antigen-protein (heat labile), Used to serotype Salmonella.
Vi antigen-Capsular antigen of Salmonella Typhi-polysaccharide (heat labile), Role in preventing phagocytosis, may mask O Ag, removed by heating.
Enterobacteriaceae are facultative anaerobes, ferment glucose. Positive nitrate and catalase, non-hemolytic. Except for Plesiomonas, they are oxidase negative.
Most medically important family of non–spore-forming gram-negative rods.
Most species are normal flora of the GI tract. Salmonella, Shigella, and Yersinia are not normal GI flora.
Major cause of nosocomial infections
Diseases include UTIs, gastroenteritis, septicemia, food poisoning, wound infections, peritonitis, pneumonia, and meningitis
The family exhibits four serological characteristics:
O (somatic) antigen-A cell wall antigen-LPS (heat stable), Used for serological grouping of Salmonella & Shigella.
K (envelope) antigen-Capsular antigen (heat labile)
H (flagellar) antigen-Flagellar antigen-protein (heat labile), Used to serotype Salmonella.
Vi antigen-Capsular antigen of Salmonella Typhi-polysaccharide (heat labile), Role in preventing phagocytosis, may mask O Ag, removed by heating.
Enterobacteriaceae are facultative anaerobes, ferment glucose. Positive nitrate and catalase, non-hemolytic. Except for Plesiomonas, they are oxidase negative.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
2. Dysentery (Shigellosis)
Dysentery is an infectious
disease, accompanied by lesion
of mucous membrane in the
large bowel, especially its distal
part
3. Etiology
• Pathogens of dysentery is Shigella, Gram-negative
• Only the pathogen of species of Grigoriev-Shiga
Sh. dysenteriae produces an exotoxin, other
pathogens produce endotoxins.
• Dysentery pathogens of various species have
different stability in the environment. Sh.
dysenteriae have the least stability
• Sh. Sonnei are the most stable. Dysentery brought
about by Sh.Sonnei is most spread these last years
while Sh.Flexneri takes the second place
4. Epidemiology
• The source of infection is patients with acute
dysentery and bacilli-carriers
• The mechanism of infection transference is fecal-
oral
• The factors of transference are food and water,
flies. Water route of infection spreading is most
typical for Sh.Flexneri, milk - Sh.Sonnei
5. • Morbidity in 1-year-old children is the
lowest, and it is the highest among the
children from 2 to 7 years of age
• Immunity in dysentery is typospecific
Epidemiology
6. Pathogenesis
• The portal of entry is gastro-intestinal tract
• On getting into the stomach, the pathogens perish
partially due to the influence of proteolytic
enzymes and hydrochloric acid in the gastric juice
• Remaining pathogens get into the small intestine
and then they get into the large intestine where
they reproduce
7. Pathogenesis
• The Shigellae have a selective ability to
adhesion (sticking) to colonocytes of the
large bowel
• Endotoxin is the leading factor - common
toxic influence on the vascular and nervous
systems of the body and its vegetative
centers
8. Clinical manifestations
• The incubation period varies from several hours
to 7 days
• The child becomes restless, loses appetite,
complains of headache and abdominal pain
• In this period the children complain of
abdominal painful cramps in defecation, drawing
pain on the side of the sigmoid colon and anus
9. • In the first hours after the onset of disease stool
has stercoral character, but by the end of the
day or the second day of the disease stercoral
masses disappear completely, stools become
poor and contain turbid mucus and blood only
10. Clinical manifestations
• Tenesmus is a typical sign of dysentery. Tenesmus
appears due to the simultaneous spasms of the
sigmoid colon and anal sphincters. In frequent
tenesmus the rectum mucous membrane prolapse
may result
• Symptoms of toxemia, pallor and dryness of the
skin are found
• On abdominal palpation, tenderness and hardening
are found over the sigmoid colon
• Moderate leukocytosis, neutrophilia with the change
to the left, insignificant increase of ESR shows in
the blood
11. Clinical type classification
Clinical type classification of dysentery is based on
the signs, which have been proposed by
A. A. Koltupin (type, severity, course)
• Typical and atypical forms are distinguished.
• In typical forms colitic syndrome is present
constantly
• Obliterated, dyspeptic, subclinical, hypertoxic forms
are referred to the atypical forms
12. Typical forms
of dysentery are divided into
• mild
• moderate
• severe
of toxemia symptoms: fever, convulsion
syndrome, mental confusion, headache,
weakness
and local alterations from gastrointestinal tract
13. 1-year-old babies has peculiarities
• Colitic syndrome is not well expressed. Stools have
enterocolitic or dyspeptic character
• Toxemia at the early age is accompanied by high
fever, recurrent vomiting
• If frequent enterocolitic stools are present,
dehydration with hemodynamic disorders may
occur
• Complications can bring about rectum mucous
membrane prolapse
• As a secondary infection, otitis, pneumonia,
stomatitis, infection of the urinary tract may occur
14. Salmonellosis
Etiology
• Pathogens of salmonellosis belong to the
Salmonella genus. There are more than 2000
serologic types of Salmonellae
• The Salmonellae groups are discerned due to the
structure of O-antigen (A, B, C, D, E and others)
• The disease in 80-90 % of the cases is connected:
S.typhimurium, S.Heidelberg, S. anatum. S.
derby, S.panama, S.enteritidis
• Pathogens have high stability in the environment
15. Epidemiology
• Salmonellosis is anthropsoonosis
• The general source of infection is various animals
• Besides, recently the sick people and bacilli carriers
present the main epidemiological danger
• The general route of infection transference is
alimentary; food
• In babies, the contact route is the main one
• Within the last years, morbidity of 1-year-old babies
has considerably increased, particularly due to
nosocomial (hospital) infection
16. Pathogenesis
• In per oral infection is destructed intensively in the
stomach and small intestine
• At this time a lot of endotoxin is released
• Due to the influence of endotoxins the toxic signs of
the disease appear
• Penetrates into the mesenteric lymph nodes and
enterocytes into blood, and causing bacteriemia
(typhus-like form, septic form)
• Salmonellae and their toxins influence the nervous
system
• Vomiting and diarrhea cause dehydration
17. Clinical manifestations
• The incubative period has duration from 2-3 hours
(in the alimentary) to 5-7 days (in the contact)
Classification
• Localization form
– gastrointestinal,
–flu-like,
–effaced
--asymptomatic
•Generalization form:
–typhus-like,
–septic
•Acute (up to 1 month), protracted (1-3 months)
•Mild, moderate and severe forms
18. Gastrointestinal form
• Has the course of gastritis, enteritis, colitis,
gastroenteritis, enterocolitis, gastro-enterocolitis
• The disease has an acute onset with fever and chills.
• Nausea and recurrent vomiting appear.
• Abdominal pain and diarrhea appear rapidly stools
become more frequent up to 3-5 times daily.
• The tongue is dry and coated. Besides, headache,
general malaise and weakness appear.
• Duration of the disease is 5-7 days.
19. • Stools are watery,
contain small
admixture of
mucus.
20. Typhus-like form of salmonellosis
Clinically it may resemble abdominal typhoid or
paratyphoid:
• duration of fever is 1-2 weeks,
• toxemia (headache, myalgia, arthralgia, anorexia),
• enlarged spleen, roseolous or erythematous rash,
• cardiovascular system disorders (bradycardia or
tachycardia),
• gastrointestinal disorders (vomiting, diarrhea, abdominal
distention).
21. Septic forms of salmonellosis
• frequent in neonates and infants younger than 6
months of age.
• Septic forms are frequently accompanied by local
lesions (meningitis, osteomyelitis, subcutaneous
abscesses, arthritis, pyelonephritis).
• The diseases can have a very severe course with
metabolic disorders of all forms, especially electrolyte
dysbalance
22. Diagnosis
• Is based on its clinical manifestations, the
epidemiological history and bacteriological test
results
• Clinical diagnosis of dysentery - typical signs of
distal colitis are present.
• Stools is the material for bacteriological tests
• Blood, stools, urine, vomiting mass, gastric water,
pus from the inflammatory foci is the material -
bacteriological tests in salmonellosis
• Material for bacteriological tests should be taken
before the antimicrobial therapy is started
23. Treatment
• Diet - recommended to reduce the volume of
food in acute period of the disease. Breast milk is
optimal nutrition
• The volume must correspond to the age norm by
the 5th-7th day after the onset of the disease
• Enzymatic therapy is administered in the
reparation stage in a course from 2 to 4 weeks
24. Etiotropic therapy
• Antibiotics (ampicillin - 100 mg/kg, ceftriaxon – 50-
75 mg/kg) should be administered in severe forms
of dysentery and salmonellosis, and the children
younger than 2 years of age.
• Furasolidone in dosage of 8-10 mg/kg,
nevigramon in dosage of 60 mg/kg, bactrim in
dosage of 60 mg/kg may be given
• In 1-year-old babies and in generalized' forms of
salmonellosis - cephalosporin (ceftazidime,
ceftriaxone in the dosage of 100 mg/kg)..
• Dysenteric and salmonellic bacteriophages may be
used to
25. Prophylaxis
• Bacteriological examination is made in all
the patients alter 2 days when the
antibacterial therapy is finished
• If epidemic outbreaks appear, all contact
persons should be examined
bacteriologically singly
27. Etiology
• E. coli are Gram-negative pathogens
• Classification includes enterohemorrhagic E. coli
(EHEC), enterotoxigenic E. coli (ETEC),
enteroinvasive E. coli (EІEC), enteropathogenic E.
coli (EPEC).
• The EPEC group of E. coli contains about 30
serotypes: O-l11; O-55; O-25; O-44; O-l19. They
cause the disease in 1-year-old babies and have
antigens similar to Salmonellae
28. Etiology
• The EIEC group of E. coli contains 13 serotypes:
O-124; O-151; O-144 and others. Their antigenic
structure is similar to that of Shigellae. EIEC group
cause the diseases in children and adults. The
disease is similar to dysentery clinically
• The ETEC group of E. coli contains the pathogens
which produce enterotoxin similar to cholerogen by
its effect. Enterotoxin causes considerable
production of liquid into the lumen of the small
bowel. These diseases have likeness with the mild
form of cholera
29. Epidemiology
• Eschirichiosis of the first group is found all year
round. 1-year-old babies get ill most frequently. The
source of infection is sick human, sometimes the
source of infection is a bacillus carrier
• Infection is caused by contact and alimentary route
• In EIEC escherichiosis infection is transmitted by
alimentary route. The disease frequently occurs in
summer and autumn
• ETEC eschcrichiosis is found among older children
and adults. The main routes of infection are food
and water
30. Pathogenesis
• E. coli enter the child's body through the mouth and
then get into the lumen of the gastrointestinal tract.
• The pathogens reproduce in the small bowel.
• They produce enterotoxins, remaining on the
surface of the mucous membrane.
• Epithelium of the small intestine is affected, and
inflammatory changes appear.
• Besides enterotoxins, endotoxins are liberated due
to the pathogen destruction
31. Clinical manifestations
EPEC eschcrichiosis occurs in 1-year-old babies.
• The incubative period is from 3 to 8 days.
• The disease has an abrupt onset - temperature
increases, weakness and anorexia
• Stools occur frequently, they are watery, yellow or
orange. If such stools occur five to seven times
daily, dehydration may occur.
• Toxemia is manifested by restlessness, recurrent
regurgitation and vomiting.
• The signs of escherichiosis in 1-year-old babies are
neurotoxicosis and toxicosis with dehydration
32. Neurotoxicosis
• occurs rarely in the first days of the disease due to
toxemia
• is characterized
hyperthermia, recurrent
vomiting, acute
restlessness, mental
confusion, tonic
convulsions, occipital
muscular stiffness,
tachycardia, toxic
breathing, protrusion of
cranial fontanel
33. Toxicosis with dehydration
• manifested by the signs of lesions,
cardiovascular, electrolyte disorders.
There are isotonic, salt deficient, water deficient
types of dehydration.
• Water deficit manifests itself by thirst,
restlessness and excitement. The skin and mucous
membranes are dry. Muscle tone is decreased,
hurried breathing, low diuresis.
34. Dehydration
• The patient eyes fall in
("sun glasses" symptom)
• The skin of the hands may
have a characteristic
appearance resembling
wrinkled "washer woman
hands"
35. • Fever, if present, is low grade, or the patient
may develop hypothermia
• The mucous membranes are dry.
• The voice becomes hoarse, weak and even
soundless.
• The pulse is weak, blood pressure is low.
• Diuresis decreases down to anuria.
Dehydration
36. Treatment
• Syndrome consists of a complex of measures:
dietary regimen, etiotropic and pathogenetic therapy.
• The patient should be given to drink by small
portions in 2-3 teaspoons every 10-15 minutes
peroral regidratation (Regidron, Oralit, ORS-200)
• Vomiting is not a contraindication for giving liquid
orally, the quantity of liquid should be reduced but it
should be administered
37. Version of calculating the daily fluid
intake (according to Velitishchev):
• The existing water deficiency in the patient (loss of
body weight).
• Replacement of the daily loss of fluids through skin
and breathing by 30 ml per kg per day and by 10 ml
per kg per day if there is an increase of the body
temperature per 1 °C.
• If there is a continuous loss due to vomiting and
diarrhea fluids should be rated at 20-30 ml per kg
per day.
38. determined by the dehydration type
• in isotonic type of dehydration a 5-10 % glucose
solution and saline solutions are administered in
correlation 1:1,
• in water-deficient dehydration (1:2-l :3) of 5-10 %
glucose solution may be given
• in salt-deficient dehydration the correlation between
saline and glucose solution is 2:1 -3:1.
Correlation of glucose and
saline solution