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GASTROENTE
RITIS
Gastroenteritis
Denotes infections of the
gastrointestinal
Infectionorirritationofthedigestive
tract,
particularlythestomachandintestin
e
Bacterial, viral, or parasitic
pathogens
EPIDEMIOLOGY
In Indias more than 2.3 million annual deaths
among children, about 334000 are attributable
to diarrhoeal diseases.
Rotavirus is the leading cause of severe
diarrhoea in children in developed and
developing countries.
Studies estimate that 90000153000 children
die from rotavirus infection in India each year
Introduction of vaccines is expected to reduce
child mortality by decreasing the incidence of
severe diarrhoea and the frequency of death
Clinical manifestations
Diarrhea
Vomiting
Abdominal pain
Fever
Weight loss
MODE OF
INFECTION
ETIOLOGY
In the United states, rotavirus and the
noroviruses are the most common viral
agents
Food-borne outbreaks of bacterial diarrhea
in the United states are most commonly
due to Salmonella, E. Coli, Clostridium
Botulinum,clostridium Perfringens, and
Staphylococcus Aureus
Waterborne outbreaks are often due to
Cryptosporidium species (most common),
C. jejuni , noroviruses,Shigella species,
Giardia , E. coli O157:H7, Plesiomonas
BACTERIA
L
Bacillus anthracis
Bacillus cereus
Brucella abortus,
B. melitensis,
and B. suis
Campylobacter
jejuni
Clostridium
botulinum:
Clostridium
perfringens toxin
Enterohemorrhag
ic Escherichia coli
(EHEC)
Enterotoxigenic
E. coli (ETEC
Listeria
monocytogenes
Salmonella spp.
Shigella spp.
Staphylococcus
aureus (
Vibrio cholerae
(toxin)
Vibrio
parahaemolyticu
s
VIRAL
Hepatitis A
Caliciviruses
(including
norovirses and
sapoviruses)
Rotavirus
Other viral
agents
(astroviruses,
adenoviruses,
parvoviruses)
PARASITIC NONINFECTI
OUS
Angiostrongylus
cantonensis
Cryptosporidium
Cyclospora
cayetanensis
Entamoeba
histolytica
Giardia lamblia
Toxoplasma
gondii
Trichinella spiralis
Antimony
Arsenic
Cadmium
Copper
Mercury
Mushroom toxins,
Nitrite poisoning
Pesticides
(organophosphate
s or carbamates)
Puffer fish
(tetrodotoxin)
Scombroid
(histamine)
Shellfish toxins
Sodium fluoride
Thallium
Tin
Vomitoxin
Zinc
Environmental contamination
Increased exposure to enteropathogens.
Young age
Immunodeficiency
Measles
Malnutrition
Lack of exclusive or predominant
breast-feeding.
COMPLICATIONS
Dehydration
Prolongation of the diarrheal
episodes, with consequent secondary
infections
Micronutrient deficiencies (iron, zinc).
In developing countries and hivinfected populations, associated
bacteremias are well-recognized
Stool Examination
Microscopic examination of the stool
and cultures can yield important
information on the etiology of
diarrhea.
Stool specimens should be examined
for mucus, blood, and leukocytes.
Fecal leukocytes indicate bacterial
invasion of colonic mucosa
TREATMENT
Antibiotic Therapy
Reduce the duration and severity of
diarrhea
Prevent complications
PREVENTION
Promotion of exclusive breast-feeding
Improved complementary feeding
practices
Rotavirus immunization
Improved water and sanitary
facilities
Promotion of personal and domestic
hygiene
Improved case management of
diarrhea
REFERENCES
NELSON TEXTBOOK OF PEDIATRICS ,
20TH EDITION
DAVIDSONS PRINCIPAL & PRACTICE
OF MEDICINE
Bulletin of WHO : Rotavirus mortality
in India: estimates based on a
nationally representative survey of
diarrhoeal deaths
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