1. Infective diarrhoea By Remilekun Odetoyinbo GPST1

2. Causes • Bacteria campylobacter salmonella e-coli Shigella Staph clotridium Cholera • Viral Rota, Adeno, Noro virus • Parasites like giardia, • Worms hook worms,pin worms • Others amoebic dysentery

3. Signs and symptoms • Diarrhoea • Abdominal pain • Vomiting • Fever • Bloating • Weight loss • Malaise • nausea

4. E coli. • Commonest cause of travellers diarrhoea • Main route is feacal to oral transmission . • Can get it from contaminated vegetables, cheese • Can be treated with amoxicillin or cephalosporin

5. Clostridium difficile. • Most serious cause of antibiotic associated diarrhoea. • Presentation is mainly after antibiotics with abdominal pain , bloating, loose foul smelling stools • Can be treated with metronidazole or vancomycin if no response.

6. Viral causes • Rota Virus • Commonest cause of severe diarrhoea in infants and children. • Incubation period of 2 days • Symptoms start with vomiting followed by 4-8 days of watery stools • More associated with dehydration than bacterial causes. • Symptomatic management and rehydration is essential

7. Viral causes • Noro virus affects all ages • Common in semiclosed or closed communities. camps, hospital, dormitories • Transmitted from person to person or from contaminated food and water • Incubation period 1-2 days. • Last for 24-60 hours. • Symptoms are mainly forceful vomiting, diarrhoea, abdominal pain • Handwashing is essential to reduce spread.

8. GardiaLamblia. • Protozoa parasite. • Got from contaminated water or faecal –oral transmission. • Causes villous atropy. • Presents with weight loss, bloating steatorrhoeaepigastric pain nausea and explosive diarrhoea • Treat with metronidazole first line . Others tinidazole,nitazoxamide

9. QUIZ • Most common cause of severe diarrhoea in infants and children • The cause of 90% of non bacterial outbreaks of diarrhoea in the world. • Antibiotic of choice for campylobacter • Commonest cause of travellers diarrhoea. • Antibiotic of choice for Clostridium difficille

10. A Rota virus B E-coli C Noro virus D Metronidazole E Erythromycin

11. True or false 1 Gardialamblia is a protozoan 2 Dehydration is twice more likely to occur in diarrhoea of bacteria origin than with rota virus 3 Noro virus infection can follow breathing air near an episode of vomiting . 4 Alcohol gel is inadequate for infection control when in contact with noro virus patients