GI Tract
❑Aka El tor
❑An acute serious illness characterized
by sudden onset of acute and profuse
colorless diarrhea, vomiting, severe
dehydration, muscular cramps, cyanosis,
and in severe cases collapse
❑CAUSATIVE AGENT ❑MODE OF
❑Vibrio Cholerae / TRANSMISSION
Vibrio Coma ❑Fecal-oral
❑Comma-shaped transmission
❑Survives longer in ❑5 Fs
refrigerated food ❑Feces
❑Produces ❑Finger
enterotoxin ❑Flies
(choleragen) ❑Food
❑Fomites
Entry of Vibrio Cholerae
Multiplication in the small intestine (choleragen)
Mucosal cell stimulation (increase cAMP, increase chloride secretion)
Water loss Potassium loss HCO3 loss
•Dehydration Hypokalemia Metabolic Acidosis
✓Excessive thirst
Kussmaul’s respiration
✓Restlessness
(rapid respiration with
✓Washerwoman’s hand
intervals of apnea)
✓Circulatory collapse / shock
❑Rectal swab
❑Darkfield or phase microscopy
❑Stool exam
❑Rice watery stool – ❑Poor tissue turgor
PATHOGNOMONIC ❑Sunken eyes
❑Inoffensive, slightly ❑Cold skin
fishy odor ❑Wrinkled toes and
❑Profuse diarrhea fingers
with no tenesmus (washerwoman’s
❑Causes fluid loss hand)
(1-30 liters/day)
❑oliguria
❑Rapid intravenous infusion (Na, K, CL, HCO3)
❑ORESOL, Hydrites
❑Coconut water (rich in potassium)
❑Pedia: continue breastfeeding
❑Antibiotics
❑Tetracycline
❑Furazolidone
❑Chloramphenicol
❑Cotrimoxazole
❑Protect food and water supplies
❑Proper storage of food
❑Medical asepsis in handling food item
❑Enteric isolation
❑Monitoring vital signs
❑Monitoring of intake and output
❑Aka. Shigellosis/ Bloody Flux
❑An acute bacterial infection of the intestine
characterized by diarrhea, fever, tenesmus and in
severe cases bloody and mucoid stool
❑MODE OF TRANSMISSION
❑Fecal-oral route – ingestion of contaminated food &
water
❑Indirect transmission (flies)
❑Sex – oro-anal contact
❑CAUSATIVE AGENT
❑Shigella Dysenteriae (Group A)
❑Shigella Flexneri (Group B)
❑Shigella boydii (Group C)
❑Shigella Connei (GroupD)
❑Fecalysis
❑Rectal swab or culture
❑Blood culture
❑Methylene blue staining
❑Fever ❑Complication: rectal
❑Tenesmus, nausea, prolapse, cough and
vomiting, headache pneumonia
❑Colicky or cramping
abdominal pain
❑Diarrhea (bloody-mucoid
stool)
❑Dehydration and rapid
weight loss
❑IV solution with normal saline (with
electrolytes)
❑Low-residue
❑Anti-diarrheal drugs (contraindicated)
❑Antibiotics
❑Ciprofloxacin
❑Ofloxacin
❑Levofloxacin
❑ORESOL
❑HMSS (home-made salt sugar)
❑Good for 24 hours
❑1-8-1
❑1 teaspoon salt
❑8 teaspoon sugar
❑1 liter water
❑aka Amoebic Dysentery
❑A protozoal infection of human beings that
initially involves the colon, but may spread to
soft tissues, most commonly the liver and
lungs, by contiguity or hematogenous or
lymphatic dissemination
❑CAUSATIVE AGENT liquid colonic contents
❑Entamoeba histolytica ❑Cyst
❑Two developmental ❑Passed out with stool
and resistant to
stage: environmental conditions
❑Considered the
❑Trophozoites / infective stage
vegetative form
❑Invades the tissue or
may be found in
parasitized tissues and
Ingestion of cyst that will pass through the stomach
(unharmed and shows no activity in acidic environment)
Cyst will mature in large intestine and will become
trophozoites
Trophozoites burrow and continue the lysis of the cells
until it gains access in the blood vessels
Trophozoites will then travel going to the hepatic veins
invading the liver and then the lungs, then other soft
tissues
❑Stool exam
❑Blood exam (leukocytosis)
❑Proctoscopy and sigmoidoscopy
❑ACUTE AMOEBIC DYSENTERY
❑Slight attack of diarrhea with watery
and foul-smelling stool often containing
blood-streaked mucus
❑Nausea, flatulence, abdominal
distension, tenderness in the right iliac
region
❑CHRONIC AMOEBIC DYSENTERY
❑Attack of dysentery succeeded by
constipation
❑Enlargement of the liver
❑Poor skin turgor over the abdomen
❑EXTRAINTESTINAL break in the lungs
FORMS ❑*Anchovy-sauce
❑RUQ pain sputum
❑Jaundice
❑Intermittent fever
❑Loss of weight
and anorexia
❑Abscess may
❑Metronidazole (Flagyl)
❑Tetracycline
❑Ampicillin
❑Streptomycin
❑Replacement of fluids and
electrolytes
❑Isolation and enteric precaution
❑Health teaching
❑Drinking water
❑Cover left over food
❑Hand washing after defecation
❑Avoid eating ground vegetables
❑Proper collection of stool specimen:
❑Instruct to avoid mixing urine with feces
❑Select large portions containing blood and
mucus as possible
❑Label the specimen properly
❑Send the specimen immediately
❑A bacterial infection transmitted by
contaminated water, milk, shellfish and
other foods
❑An infection of the GIT affecting
lymphoid tissues of the small intestines
(Payer’s patches)
❑CAUSATIVE AGENT ❑MODE OF
❑Salmonella TRANSMISSION
typhosa/typhi ❑Fecal-oral
❑Pathogenic only to transmission
human ❑5 Fs
❑Feces
❑Finger
❑Flies
❑Food
❑Fomites
❑Ingestion of S. Typhi ulcerations
❑Propagation of the ❑Leak of bowel
MO in the stomach contents into the
❑MO travel to the abdomen
small intestines ❑MO is absorbed into
(Payer’s patches) circulation
❑Inflammation of the ❑Reaches different
small intestinal linings organs of the body
❑Small intestinal
❑Typhidot (confirmatory)
❑Uses blood or stool
❑ELISA
❑Rectal swab
❑Widal test
❑Agglutination test for O and H Ag
❑O Ag – somatic body
❑H Ag – flagellar
❑V Ag – carbohydrate envelop
❑ONSET STATE
❑Headache, chilly sensation, body aches
❑Nausea, vomiting, and diarrhea
❑4th and 5th days (symptoms are worst)
❑7th to 9th days (Rose spots)
❑TYPHOID STATE
❑Subsultus tendinum
❑Coma vigil
❑Carphologia
❑Delirium
❑Chloramphenicol (Drug of choice)
❑Ampicillin
❑Co-trimoxazole
❑Ciprofloxacin/ceftriaxone
❑Isolation by medical aseptic technique
❑Maintenance of fluid and electrolytes
balance
❑Monitor vital signs
❑Prevent injury
❑Mouth care
❑Cooling measures during febrile stage
❑WOF signs of intestinal bleeding
❑Terminal and concurrent disinfection
❑Vaccine-preventable liver infection, caused
by HAV, the most benign and harmless type of
hepatitis
❑The MOT
❑Fecal-oral route
❑Ingestion of contaminated water/food
❑Close contact with an infected person
❑Having oro-anal sex
❑Sharing of needles
❑Ingestion of contaminated food or water
❑Reaches the liver
❑Interlobular infiltration
❑Necrosis and hyperplasia of Kupffer
cells
❑Bile fails to reach the intestines
❑Dark urine, pale stools, itchiness
❑HAV and HBV complement fixation rate
❑Serum glutamic oxaloacetic
transaminase (SGOT)
❑Serum glutamic pyruvic transaminase
(SGPT)
❑Serum alanine transaminase (ALT)
❑Bile examination (stool and urine)
❑IgM level
❑Fatigue, low-grade fever, anorexia, N&V
❑Pain on the right side of the abdomen
beneath the lower ribs
❑Pale stools
❑Dark urine
❑Arthralgia
❑Jaundice
❑Intense itching
❑No specific treatment
❑High carbohydrate, low fat, low CHON
❑Vit. B complex
❑Isoprinosine
❑Belladonna
❑Antiemetics
❑Hepatitis A vaccine
❑Enteric isolation
❑Bed rest
❑Observe for melena
❑Skin and mouth care
❑Limit activity when fatigued
❑Plan periods of rest and activity
❑Gradual resumption of activities
