复旦大学：《传染病学 Infectious diseases》课程教学资源（PPT课件）腹泻 diarrhea

Diarrhea Ning Li Department of Infectious Diseases Huashan Hospita

Diarrhea Ning Li Department of Infectious Diseases Huashan Hospital 1

Diarrheal illness is one of the leading causes of death worldwide It is most commonly encountered in developing countries Can be life-threatening in infants, young children and elderly people Most individuals with this illness can be managed as outpatients

• Diarrheal illness is one of the leading causes of death worldwide. • It is most commonly encountered in develeoping countries. • Can be life-threatening in infants, young children, and elderly people. Most individuals with this illness can be managed as outpatients. 2

The pathogens that cause diarrhea can be transmitted through food throug th water through person-to-person

The pathogens that cause diarrhea can be transmitted through food through water through person-to-person 3

diarrhea Acute hronic bacterial Antibiotic associatd parasitic

diarrhea Acute bacterial Antibiotic￾associatd viral chronic parasitic 4

Acute diarrhea Bacterial viral antibiotic associatd

Acute diarrhea viral Antibiotic￾associatd Bacterial 5

Bacterial diarrhea

Bacterial diarrhea 6

Microbiology, pathogenesis, and epidemiology salmonella shigella campylobacter Vibrio Escherichia coli parahaemolyticus yersinia

Microbiology,pathogenesis,and epidemiology salmonella shigella camylobacter Escherichia coli Vibrio parahaemolyticus yersinia 7

case1 A 52-year-old black woman with rheumatoid arthritis complaints of fever and diarrhea for the preceding 24 hours hospitalized for neck surgery and received a 10-day course of a broad spectrum antibiotic( ceftazidime) developed a fever to 38. 9c associated with shaking chills and persistent severe watery diarrhea (25 to 30 bowel movements daily)

case1 • A 52-year-old black woman with rheumatoid arthritis • complaints of fever and diarrhea for the preceding 24 hours. • hospitalized for neck surgery and received a 10-day course of a broad￾spectrum antibiotic (ceftazidime). • developed a fever to 38.9C associated with shaking chills and persistent severe watery diarrhea (25 to 30 bowel movements daily). 8

noted abdominal cramps, nausea, vomiting and anorexia Medications: asparin and large quantities of antacids Epidemioly: Her son had brought her an egg salad sandwich which they shared 16 hours before onset of the illness. Her son also has severe diarrhea Physical examination: T 39 C BP70/50 mm Hg, P 120/min, R 20/min moderately ill-appearing, with dry mucous membranes and a dry fissured tongue. Abdomenal exam revealed hyperactive bowel sounds and mild diffuse tenderness No skin lesions were seen

• noted abdominal cramps, nausea, vomiting, and anorexia. • Medications: asparin and large quantities of antacids. • Epidemioly: Her son had brought her an egg salad sandwich, which they shared 16 hours before onset of the illness. Her son also has severe diarrhea. • Physical examination: T 39℃, BP70/50 mm Hg, P 120/min,R 20/min • moderately ill-appearing, with dry mucous membranes and a dry, fissured tongue. Abdomenal exam revealed hyperactive bowel sounds and mild diffuse tenderness • No skin lesions were seen. 9

Laboratory findings: WBC 7100/ mm3, with 10%PMNs, 63% bands 19% lymphocytes blood urea nitrogen of 63 mg/dL; and serum creatinine of 2. 1 mg/dL Methylene blue smear of the stool few PMNs and few mononuclear cells. Gram stain: mixed flora. Stool culture Salmonella enteritidis The case summarizes the characteristics of the most common bacterial causes of diarrhea

• Laboratory findings: WBC 7100/mm3, with 10% PMNs, 63% bands, 19% lymphocytes; blood urea nitrogen of 63 mg/dL; and serum creatinine of 2.1 mg/dL. Methylene blue smear of the stool: few PMNs and few mononuclear cells. Gram stain: mixed flora. Stool culture: Salmonella enteritidis. The case summarizes the characteristics of the most common bacterial causes of diarrhea. 10