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Gastroenteritis
In this article
Symptoms of Gastroenteritis
Stomach Flu and Children
What Causes Gastroenteritis
When you have diarrhea and vomiting, you may say you have the "stomach flu." Whatit's really called is gastroenteritis.
Although it may mae you feel !ad, it's an illness that has nothing to do really ith flu. In
gastroenteritis, your stomach and intestines are irritated and inflamed. #he cause is
typically a viral or !acterial infection.
Symptoms of Gastroenteritis
With gastroenteritis, the main symptoms you pro!a!ly have are atery diarrhea and
vomiting. $ou might also have stomach pain, cramping, fever , nausea, and a headache.
%ecause of diarrhea and vomiting, you also can !ecome dehydrated. Watch for signs of
dehydration, such as dry sin and a dry mouth, feeling lightheaded, and !eing really
thirsty. Call your doctor if you have any of these symptoms.Stomach Flu and Children
Children can get dehydrated &uicly, so if your child has the stomach flu, it's important
that you loo for signs that he is very thirsty or has dry sin or a dry mouth. If you have a !a!y, loo for feer, drier diapers.
eep children ith gastroenteritis out of day care or school until all symptoms are gone.
Chec ith your doctor !efore giving your child any medicine. (rugs used to control
diarrhea and vomiting aren't usually given to children younger than ).
#o help prevent rotavirus ** the most common cause of stomach flu for children ** there
are to vaccines that can !e given to infants. #al to your doctor a!out the vaccines.
What Causes Gastroenteritis#here are many ays gastroenteritis can !e spread+
Contact ith someone ho has the virus
Contaminated food or ater
nashed hands after going to the !athroom or changing a diaper
#he most common cause of gastroenteritis is a virus. Gastroenteritis flu can !e caused !ymany different inds of viruses. #he main types are rotavirus and norovirus.
-otavirus is the orld's most common cause of diarrhea in infants and young children.
orovirus is the most common cause of serious gastroenteritis and also food !orne
disease out!reas in the .S.
Although not as common, !acteria such as /. coli and salmonella can also trigger the
stomach flu. Salmonella and campylo!acter !acteria are the most common !acterialcauses of gastroenteritis in the .S. and are usually spread !y undercooed poultry, eggs,
or poultry 0uices. Salmonella can also !e spread through pet reptiles or live poultry.
Another !acteria, shigella, is often passed around in day care centers. It typically is
spread from person to person, and common sources of infection are contaminated food
and drining ater.
http://www.webmd.com/digestive-disorders/gastroenteritis#1http://www.webmd.com/digestive-disorders/gastroenteritis#2http://www.webmd.com/digestive-disorders/gastroenteritis#3http://www.webmd.com/digestive-disorders/digestive-diseases-diarrheahttp://www.webmd.com/digestive-disorders/digestive-diseases-nausea-vomitinghttp://www.webmd.com/digestive-disorders/gastroenteritishttp://www.webmd.com/cold-and-flu/default.htmhttp://www.webmd.com/cold-and-flu/default.htmhttp://www.webmd.com/digestive-disorders/picture-of-the-stomachhttp://www.webmd.com/digestive-disorders/picture-of-the-intestineshttp://www.webmd.com/a-to-z-guides/bacterial-and-viral-infectionshttp://www.webmd.com/pain-management/guide/abdominal-pain-causes-treatmentshttp://www.webmd.com/first-aid/fevers-causes-symptoms-treatmentshttp://www.webmd.com/migraines-headaches/default.htmhttp://www.webmd.com/a-to-z-guides/dehydration-adultshttp://www.webmd.com/a-to-z-guides/dehydration-adultshttp://www.webmd.com/oral-health/guide/dental-health-dry-mouthhttp://www.webmd.com/drugs/index-drugs.aspxhttp://www.webmd.com/vaccines/default.htmhttp://www.webmd.com/digestive-disorders/gastroenteritis#2http://www.webmd.com/digestive-disorders/gastroenteritis#3http://www.webmd.com/digestive-disorders/digestive-diseases-diarrheahttp://www.webmd.com/digestive-disorders/digestive-diseases-nausea-vomitinghttp://www.webmd.com/digestive-disorders/gastroenteritishttp://www.webmd.com/cold-and-flu/default.htmhttp://www.webmd.com/digestive-disorders/picture-of-the-stomachhttp://www.webmd.com/digestive-disorders/picture-of-the-intestineshttp://www.webmd.com/a-to-z-guides/bacterial-and-viral-infectionshttp://www.webmd.com/pain-management/guide/abdominal-pain-causes-treatmentshttp://www.webmd.com/first-aid/fevers-causes-symptoms-treatmentshttp://www.webmd.com/migraines-headaches/default.htmhttp://www.webmd.com/a-to-z-guides/dehydration-adultshttp://www.webmd.com/a-to-z-guides/dehydration-adultshttp://www.webmd.com/oral-health/guide/dental-health-dry-mouthhttp://www.webmd.com/drugs/index-drugs.aspxhttp://www.webmd.com/vaccines/default.htmhttp://www.webmd.com/digestive-disorders/gastroenteritis#1
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1arasites can also cause gastroenteritis, !ut it's not common. $ou can pic up organisms
such as giardia and cryptosporidium in contaminated simming pools or !y drining
contaminated ater.
#here are also other unusual ays to get gastroenteritis+
2eavy metals 3arsenic, cadmium, lead, or mercury4 in drining ater
/ating a lot of acidic foods, lie citrus fruit and tomatoes#o5ins that might !e found in certain seafood
6edications such as anti!iotics, antacids, la5atives, and chemotherapy drugs
2ave you ever had the "stomach flu7" What you pro!a!ly had as gastroenteritis * not a
type of flu at all. Gastroenteritis is an inflammation of the lining of the intestines caused
!y a virus, !acteria or parasites. 8iral gastroenteritis is the second most common illness
in the .S. #he cause is often a norovirus infection. It spreads through contaminated food
or ater, and contact ith an infected person. #he !est prevention is fre&uent hand
ashing.
Symptoms of gastroenteritis include diarrhea, a!dominal pain, vomiting, headache, fever
and chills. 6ost people recover ith no treatment.#he most common pro!lem ith gastroenteritis is dehydration. #his happens if you do
not drin enough fluids to replace hat you lose through vomiting and diarrhea.
(ehydration is most common in !a!ies, young children, the elderly and people ith ea immune systems.
NIH: National Institute of Diabetes and Digestive and Kidney DiseasesGastroenteritis or infectious diarrhea is a medical condition from inflammation 3"-
itis" 4 of the gastrointestinal tract that involves !oth the stomach 3"gastro" *4 and the small
intestine 3"entero" *4. It causes some com!ination of diarrhea, vomiting,
and a!dominal pain and cramping.9:; (ehydration may occur as a result. Gastroenteritis
has !een referred to as gastro, stomach bug, andstomach virus. Although unrelatedto influen; and Campylo!acter9?; are more common. @ess common causes include
other !acteria 3or their to5ins4 and parasites. #ransmission may occur due to consumption
of improperly prepared foods or contaminated ater or via close contact ith individualsho are infectious. 1revention includes the use of fresh ater, regular hand ashing, and
!reast feeding especially in areas here sanitation is less good. #he rotavirus vaccine is
recommended for all children.
#he ey treatment is enough fluids. For mild or moderate cases, this can typically !e
achieved via oral rehydration solution 3a com!ination of ater, salts, and sugar4. In those
ho are !reast fed, continued !reast feeding is recommended. For more severe cases,intravenous fluids from a healthcare centre may !e needed. Anti!iotics are generally not
recommended. Gastroenteritis primarily affects children and those in the developing
orld. It results in a!out three to five !illion cases and causes :.? million deaths a year.
Signs and symptoms
http://www.nlm.nih.gov/medlineplus/norovirusinfections.htmlhttp://www.nlm.nih.gov/medlineplus/diarrhea.htmlhttp://www.nlm.nih.gov/medlineplus/dehydration.htmlhttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Gastrointestinal_tracthttp://en.wikipedia.org/wiki/Stomachhttp://en.wikipedia.org/wiki/Small_intestinehttp://en.wikipedia.org/wiki/Small_intestinehttp://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Vomitinghttp://en.wikipedia.org/wiki/Abdomenhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Influenzahttp://en.wikipedia.org/wiki/Rotavirushttp://en.wikipedia.org/wiki/Rotavirushttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-pmid22030330-2http://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-pmid21695033-3http://en.wikipedia.org/wiki/Campylobacterhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-pmid22025030-4http://en.wikipedia.org/wiki/Rotavirus_vaccinehttp://en.wikipedia.org/wiki/Oral_rehydration_solutionhttp://en.wikipedia.org/wiki/Oral_rehydration_solutionhttp://www.nlm.nih.gov/medlineplus/norovirusinfections.htmlhttp://www.nlm.nih.gov/medlineplus/diarrhea.htmlhttp://www.nlm.nih.gov/medlineplus/dehydration.htmlhttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Gastrointestinal_tracthttp://en.wikipedia.org/wiki/Stomachhttp://en.wikipedia.org/wiki/Small_intestinehttp://en.wikipedia.org/wiki/Small_intestinehttp://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Vomitinghttp://en.wikipedia.org/wiki/Abdomenhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Influenzahttp://en.wikipedia.org/wiki/Rotavirushttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-pmid22030330-2http://en.wikipedia.org/wiki/Norovirushttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-pmid21695033-3http://en.wikipedia.org/wiki/Campylobacterhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-pmid22025030-4http://en.wikipedia.org/wiki/Rotavirus_vaccinehttp://en.wikipedia.org/wiki/Oral_rehydration_solution
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#ype on the %ristol stool chartindicates diarrhea
Gastroenteritis typically involves !oth diarrhea and vomiting,9);
or less commonly, presents ith only one or the other.9:; A!dominal cramping may also !e present.9:; Signs
and symptoms usually !egin :=B= hours after contracting the infectious agent.9; If due
to a viral agent, the condition usually resolves ithin one ee.9); Some viral causes may
also !e associated ith fever , fatigue, headache, andmuscle pain.9); If the stool is !loody,
the cause is less liely to !e viral9); and more liely to !e !acterial.9; Some !acterial
infections may !e associated ith severe a!dominal pain and may persist for several
ees.9;
Children infected ith rotavirus usually mae a full recovery ithin three to eight days.9D; 2oever, in poor countries treatment for severe infections is often out of reach and
persistent diarrhea is common.9E; (ehydration is a common complication of diarrhea,9:; and a child ith a significant degree of dehydration may have a prolonged capillary
refill, poor sin turgor , and a!normal !reathing.9::; -epeat infections are typically seen in
areas ith poor sanitation, and malnutrition,9; stunted groth, and long*term cognitive
delays can result.9:=;
-eactive arthritis occurs in : of people folloing infections
ith Campylobacter species, and Guillain*%arre syndrome occurs in .:.9; 2emolytic
uremic syndrome 32S4 may occur due to infection ith Shiga to5in*
producing Escherichia coli or higella species, causing lo platelet counts, poor idney
function, and lo red !lood cell count 3due to their !readon4.9:>; Children are more
predisposed to getting 2S than adults.9:=; Some viral infections may produce !enign
infantile sei
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of infection is higher in children due to their lac of immunity and relatively poor
hygiene.9:;
Viral
-otavirus, norovirus, adenovirus, and astrovirus are non to cause viral gastroenteritis.9);9:); -otavirus is the most common cause of gastroenteritis in children,9:?; and produces
similar rates in !oth the developed and developing orld.9D; 8iruses cause a!out ofepisodes of infectious diarrhea in the pediatric age group.9:; -otavirus is a less common
cause in adults due to ac&uired immunity.9:; orovirus is the cause in a!out :D of all
cases.9:D;
orovirus is the leading cause of gastroenteritis among adults in America, causing greater
than E of out!reas.9); #hese locali
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#ransmission may occur via consumption of contaminated ater, or hen people share
personal o!0ects.9; In places ith et and dry seasons, ater &uality typically orsens
during the et season, and this correlates ith the time of out!reas.9; In areas of the
orld ith four seasons, infections are more common in the inter .9:=; %ottle*feeding of
!a!ies ith improperly saniti
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A determination of hether or not the person has dehydration is an important part of the
assessment, ith dehydration typically divided into mild 3>B)4, moderate 3BE4, and
severe 3J:4 cases.9:; In children, the most accurate signs of moderate or severe
dehydration are a prolonged capillary refill, poor sin turgor , and a!normal !reathing.9::;
9=D;ther useful findings 3hen used in com!ination4 include sunen eyes, decreased
activity, a lac of tears, and a dry mouth. 9:; A normal urinary output and oral fluid intaeis reassuring.9::; @a!oratory testing is of little clinical !enefit in determining the degree of
dehydration.9:;
Differential diagnosis
ther potential causes of signs and symptoms that mimic those seen in gastroenteritis that
need to !e ruled out include appendicitis, volvulus, inflammatory !oel disease,urinary
tract infections, and dia!etes mellitus.9:; 1ancreatic insufficiency, short !oel
syndrome, Whipple's disease, coeliac disease, and la5ative a!use should also !e
considered.9=E; #he differential diagnosis can !e complicated somehat if the person
e5hi!its only vomiting or diarrhea 3rather than !oth4.9:;
Appendicitis may present ith vomiting, a!dominal pain, and a small amount of diarrheain up to >> of cases.9:; #his is in contrast to the large amount of diarrhea that is typical
of gastroenteritis.9:; Infections of the lungs or urinary tract in children may also cause
vomiting or diarrhea.9:; Classical dia!etic etoacidosis 3(A4 presents ith a!dominal pain, nausea, and vomiting, !ut ithout diarrhea.9:; ne study found that : of children
ith (A ere initially diagnosed as having gastroenteritis.9:;
1revention
A supply of easily accessi!le uncontaminated ater and good sanitation practices are
important for reducing rates of infection and clinically significant gastroenteritis.9:=; 1ersonal measures 3such as hand ashing ith soap4 have !een found to decrease
incidence and prevalence rates of gastroenteritis in !oth the developing and developedorld !y as much as >.9::; Alcohol*!ased gels may also !e effective.9::; %reastfeeding is important, especially in places ith poor hygiene, as is improvement
of hygiene generally.9; %reast mil reduces !oth the fre&uency of infections and their
duration.9:; Avoiding contaminated food or drin should also !e effective. 9>;
Vaccination
(ue to !oth its effectiveness and safety, in =E the World 2ealth rgani:; #o
commercial rotavirus vaccines e5ist and several more are in development.9>:; In Africa
and Asia these vaccines reduced severe disease among infants 9>:; and countries that have
put in place national immuni=;9>>; #his vaccine may also prevent illness in non*vaccinated children !yreducing the num!er of circulating infections.9>?; Since =, the implementation of a
rotavirus vaccination program in the nited States has su!stantially decreased the
num!er of cases of diarrhea !y as much as D percent.9>);9>;9>; #he first dose of vaccine
should !e given to infants !eteen and :) ees of age.9:?; #he oral cholera vaccine has
!een found to !e )B effective over = years.9>D;
6anagement
http://en.wikipedia.org/wiki/Dehydrationhttp://en.wikipedia.org/wiki/Dehydrationhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Capillary_refillhttp://en.wikipedia.org/wiki/Skin_turgorhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Tint10-11http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-28http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Tint10-11http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Appendicitishttp://en.wikipedia.org/wiki/Volvulushttp://en.wikipedia.org/wiki/Inflammatory_bowel_diseasehttp://en.wikipedia.org/wiki/Inflammatory_bowel_diseasehttp://en.wikipedia.org/wiki/Urinary_tract_infectionhttp://en.wikipedia.org/wiki/Urinary_tract_infectionhttp://en.wikipedia.org/wiki/Diabetes_mellitushttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Webb2005-16http://en.wikipedia.org/wiki/Short_bowel_syndromehttp://en.wikipedia.org/wiki/Short_bowel_syndromehttp://en.wikipedia.org/wiki/Whipple's_diseasehttp://en.wikipedia.org/wiki/Coeliac_diseasehttp://en.wikipedia.org/wiki/Laxativehttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Oxford-29http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Diabetic_ketoacidosishttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Sanitationhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-M93-12http://en.wikipedia.org/wiki/Hand_washinghttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Tint10-11http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Tint10-11http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Tint10-11http://en.wikipedia.org/wiki/Breastfeedinghttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Web09-6http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Web09-6http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-30http://en.wikipedia.org/wiki/Rotavirus_vaccinehttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Sz2010-14http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Sz2010-14http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHORota2009-31http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHORota2009-31http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHORota2009-31http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHORota2009-31http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-32http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-33http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-34http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-CDC_Rota-35http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-36http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-37http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Sz2010-14http://en.wikipedia.org/wiki/Cholera_vaccinehttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-38http://en.wikipedia.org/wiki/Dehydrationhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Capillary_refillhttp://en.wikipedia.org/wiki/Skin_turgorhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Tint10-11http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-28http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Tint10-11http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Appendicitishttp://en.wikipedia.org/wiki/Volvulushttp://en.wikipedia.org/wiki/Inflammatory_bowel_diseasehttp://en.wikipedia.org/wiki/Urinary_tract_infectionhttp://en.wikipedia.org/wiki/Urinary_tract_infectionhttp://en.wikipedia.org/wiki/Diabetes_mellitushttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Webb2005-16http://en.wikipedia.org/wiki/Short_bowel_syndromehttp://en.wikipedia.org/wiki/Short_bowel_syndromehttp://en.wikipedia.org/wiki/Whipple's_diseasehttp://en.wikipedia.org/wiki/Coeliac_diseasehttp://en.wikipedia.org/wiki/Laxativehttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Oxford-29http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Diabetic_ketoacidosishttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Sanitationhttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-M93-12http://en.wikipedia.org/wiki/Hand_washinghttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Tint10-11http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Tint10-11http://en.wikipedia.org/wiki/Breastfeedinghttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Web09-6http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-30http://en.wikipedia.org/wiki/Rotavirus_vaccinehttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Sz2010-14http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHORota2009-31http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHORota2009-31http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHORota2009-31http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-32http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-33http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-34http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-CDC_Rota-35http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-36http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-37http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-Sz2010-14http://en.wikipedia.org/wiki/Cholera_vaccinehttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-38
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Gastroenteritis is usually an acute and self*limiting disease that does not re&uire
medication.9:; #he preferred treatment in those ith mild to moderate dehydration is oral
rehydration therapy 3-#4.9:>; 6etoclopramide andKor ondansetron, hoever, may !e
helpful in some children,9>E; and !utylscopolamine is useful in treating a!dominal pain.9?;
Rehydration
#he primary treatment of gastroenteritis in !oth children and adults is rehydration. #his is prefera!ly achieved !y oral rehydration therapy, although intravenous delivery may !e
re&uired if there is a decreased level of consciousness or if dehydration is severe.9?:;
9?=; ral replacement therapy products made ith comple5 car!ohydrates 3i.e. those made
from heat or rice4 may !e superior to those !ased on simple sugars.9?>; (rins especially
high in simple sugars, such as soft drins and fruit 0uices, are not recommended in
children under ) years of age as they may increase diarrhea.9:; 1lain ater may !e used if
more specific and effective -# preparations are unavaila!le or are not palata!le.9:;A nasogastric tu!e can !e used in young children to administer fluids if arranted.9:;
Dietary
It is recommended that !reast*fed infants continue to !e nursed in the usual fashion, andthat formula*fed infants continue their formula immediately after rehydration ith -#.9??; @actose*free or lactose*reduced formulas usually are not necessary.9??; Children should
continue their usual diet during episodes of diarrhea ith the e5ception that foods highin simple sugars should !e avoided.9??; #he %-A# diet 3!ananas, rice, applesauce, toast
and tea4 is no longer recommended, as it contains insufficient nutrients and has no !enefit
over normal feeding.9??; Some pro!iotics have !een shon to !e !eneficial in reducing
!oth the duration of illness and the fre&uency of stools.9?);9?; #hey may also !e useful in
preventing and treating anti!iotic associated diarrhea.9?; Fermented mil products 3such
as yogurt4 are similarly !eneficial.9?D; Linc supplementation appears to !e effective in !oth
treating and preventing diarrhea among children in the developing orld.9?E;
Antiemetics
Antiemetic medications may !e helpful for treating vomiting in
children. ndansetron has some utility, ith a single dose !eing associated ith less need
for intravenous fluids, feer hospitali; #he intravenous
preparation of ondansetron may !e given orally if clinical 0udgment arrants.9)?; (imenhydrinate, hile reducing vomiting, does not appear to have a significant
clinical !enefit.9:;
Antibiotics
Anti!iotics are not usually used for gastroenteritis, although they are sometimesrecommended if symptoms are particularly severe9)); or if a suscepti!le !acterial cause is
isolated or suspected.9); If anti!iotics are to !e employed, a macrolide 3such
as a
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treatment include higella9)D; almonella typhi,9)E; and iardia species.9=?; In those
ith iardia species or Entamoeba histolytica, tinida
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Gastroenteritis is the main reason for >. million visits to physicians a year in the nited
States9:; and > million visits in France.9; In the nited States gastroenteritis as a hole is
!elieved to result in costs of => !illion S( per year 9:; ith that due to rotavirus alone
resulting in estimated costs of : !illion S( a year .9:;
-esearch
#here are a num!er of vaccines against gastroenteritis in development. For e5ample,vaccines against higella and enteroto5igenic Escherichia coli 3/#/C4, to of the
leading !acterial causes of gastroenteritis orldide.9=;9>;
ther animals
6any of the same agents cause gastroenteritis in cats and dogs as in humans. #he most
common organisms are Campylobacter , Clostridium difficile, Clostridium perfringens,
and almonella.9?; A large num!er of to5ic plants may also cause symptoms.9);
Some agents are more specific to a certain species. #ransmissi!le gastroenteritis
coronavirus 3#G/84 occurs in pigs resulting in vomiting, diarrhea, and dehydration.9; It
is !elieved to !e introduced to pigs !y ild !irds and there is no specific treatment
availa!le.9;
It is not transmissi!le to humans.9D;
Gastroenteritis is an illness triggered !y the infection and inflammation of the digestive
system. #ypical symptoms include a!dominal cramps, diarrhoea and vomiting. In many
cases, the condition heals itself ithin a fe days.
#he main complication of gastroenteritis is dehydration, !ut this can !e prevented if the
fluid lost in vomit and diarrhoea is replaced. A person suffering from severe
gastroenteritis may need fluids administered intravenously 3directly into the !loodstream
via a vein B the setup is often referred to as a MdripN4. Some of the causes of gastroenteritis
include viruses, !acteria, !acterial to5ins, parasites, particular chemicals and some drugs.
Symptoms of gastroenteritis
• @oss of appetite
• %loating
• ausea
• 8omiting
•
A!dominal cramps• A!dominal pain
• (iarrhoea
• %loody stools 3poo4 B in some cases
• 1us in the stools B in some cases
• Generally feeling unell, including lethargy and !ody aches.
http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-70http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-71http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHO_ETEC-72http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHO_Shig-73http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-74http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-75http://en.wikipedia.org/wiki/Transmissible_gastroenteritis_coronavirushttp://en.wikipedia.org/wiki/Transmissible_gastroenteritis_coronavirushttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-76http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-77http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-ZimmermanKarriker2012-78http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-70http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-71http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-EBMED2010-1http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHO_ETEC-72http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-WHO_Shig-73http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-74http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-75http://en.wikipedia.org/wiki/Transmissible_gastroenteritis_coronavirushttp://en.wikipedia.org/wiki/Transmissible_gastroenteritis_coronavirushttp://en.wikipedia.org/wiki/Gastroenteritis#cite_note-76http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-77http://en.wikipedia.org/wiki/Gastroenteritis#cite_note-ZimmermanKarriker2012-78
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auses of gastroenteritis
• Viruses B such as norovirus, calicivirus, rotavirus, astrovirus and adenovirus
• !acteria B such as the Campylobacter !acterium
• Parasites B such as Entamoeba histolytica$ iardia lamblia and Cryptosporidium
• !acterial to"ins B the !acteria themselves donNt cause illness, !ut their poisonous
!y*products can contaminate food. Some strains of staphylococcal !acteria
produce to5ins that can cause gastroenteritis
• hemicals B lead poisoning, for e5ample, can trigger gastroenteritis
• #edications B certain medications, such as anti!iotics, can cause gastroenteritis in
suscepti!le people.
$nfectious gastroenteritis
•
%scherichia coli infection B this is a common pro!lem for travellers to countriesith poor sanitation. Infection is caused !y drining contaminated ater or eating
contaminated ra fruits and vegeta!les.
• ampylobacter infection B the !acteria are found in animal faeces 3poo4 and
uncooed meat, particularly poultry. Infection is caused !y, for e5ample,
consuming contaminated food or ater, eating undercooed meat 3especially
chicen4, and not ashing your hands after handling infected animals.
• ryptosporidium infection B parasites are found in the !oels of humans and
animals. Infection is caused !y, for e5ample, simming in a contaminated pool
and accidentally salloing ater, or through contact ith infected animals. Aninfected person may spread the parasites to food or surfaces if they donNt ash
their hands after going to the toilet.
• Giardiasis B parasite infection of the !oel. Infection is caused !y, for e5ample,
drining contaminated ater, handling infected animals or changing the nappy of
an infected !a!y and not ashing your hands afterards.
• Salmonellosis B !acteria are found in animal faeces. Infection is caused !y eating
contaminated food or handling infected animals. An infected person may also
spread the !acteria to other people or surfaces !y not ashing their hands properly.
•Shigellosis B !acteria are found in human faeces. An infected person may spreadthe !acteria to food or surfaces if they donNt ash their hands after going to the
toilet.
• Viral gastroenteritis B infection is caused !y person*to*person contact such as
touching contaminated hands, faeces or vomit, or !y drining contaminated ater
or food.
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Diagnosis of gastroenteritis
It is important to esta!lish the cause, as different types of gastroenteritis respond to
different treatments. (iagnostic methods may include+
• 6edical history
• 1hysical e5amination
• %lood tests
• Stool tests.
Treatment for gastroenteritis
#reatment depends on the cause, !ut may include+
• 1lenty of fluids
• ral rehydration drins, availa!le from your pharmacist
•
Admission to hospital and intravenous fluid replacement, in severe cases• Anti!iotics, if !acteria are the cause
• (rugs to ill the parasites, if parasites are the cause
• Avoiding anti*vomiting or anti*diarrhoea drugs unless prescri!ed or recommended
!y your doctor, !ecause these medications ill eep the infection inside your
!ody.
Prevention of gastroenteritis
General suggestions on ho to reduce the ris of gastroenteritis include+
• Wash hands thoroughly ith soap and ater after going to the toilet or changing
nappies, after smoing, after using a handerchief or tissue, or after handling
animals.
• Wash your hands thoroughly ith soap and ater !efore preparing food or eating.
• se disposa!le paper toels to dry your hands rather than cloth toels, since the
!acteria can survive for some time on o!0ects.
• (o not handle ra and cooed foods ith the same implements 3tongs, nives,
cutting !oards4, unless they have !een thoroughly ashed !eteen uses.• eep all itchen surfaces and e&uipment clean.
• eep cold food cold 3!elo ) OC4 and hot food hot 3a!ove OC4 to discourage
the groth of !acteria.
• 6ae sure foods are thoroughly cooed.
• Clean the toilet and !athroom regularly, especially the toilet seat, door handles and
taps.
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• Clean !a!y change ta!les regularly.
• When travelling overseas to countries here sanitation is suspect, only drin
!ottled ater. (onNt forget to !rush your teeth in !ottled ater too. Avoid food
!uffets, uncooed foods or peeled fruits and vegeta!les, and ice in drins.
Things to remember
• Gastroenteritis is a short*term illness triggered !y the infection and inflammation
of the digestive system.
• Symptoms can include a!dominal cramps, diarrhoea and vomiting.
• Some of the causes of gastroenteritis include viruses, !acteria, !acterial to5ins,
parasites, particular chemicals and some drugs.
Are there any complications that can occur from gastroenteritis7
Complications from gastroenteritis in children are uncommon in the . #hey are more
liely in very young children. #hey are also more liely if your child has an ongoing
3chronic4 illness such as dia!etes, or if their immune system is not oring fully. For
e5ample, if they are taing long*term steroid medication or they are having chemotherapy
treatment for cancer. 1ossi!le complications include the folloing+
• &ac' of fluid and salt (electrolyte) imbalance in the body. #his is the most
common complication. It occurs if the ater and salts that are lost in your child's
stools 3faeces4, or hen they have !een sic 3vomited4, are not replaced !y themdrining enough fluids. If your child drins ell, then it is unliely to occur, or is
only liely to !e mild and ill soon recover as your child drins.
• Reactive complications. -arely, other parts of the !ody can react to an infection
that occurs in the gut 3intestines4. #his can cause symptoms such as 0oint
inflammation 3arthritis4, sin inflammation and eye inflammation 3either
con0unctivitis or uveitis4. -eactive complications are uncommon if it is a virus
causing gastroenteritis.
• Spread of infection to other parts of your child's !ody such as their !ones, 0oints,
or the meninges that surround their !rain and spinal cord. #his is rare. If it does
occur, it is more liely if gastroenteritis is caused !y almonella spp. infection.
• Persistent diarrhoea syndromes may rarely develop.
http://www.patient.co.uk/health/salmonella-leaflethttp://www.patient.co.uk/health/salmonella-leaflethttp://www.patient.co.uk/health/salmonella-leaflet
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• $rritable bo*el syndrome is sometimes triggered !y a !out of gastroenteritis.
• &actose intolerance can sometimes occur for a hile after gastroenteritis. It is
non as secondary or ac&uired lactose intolerance. $our child's gut lining can !e
damaged !y the episode of gastroenteritis. #his leads to lac of a chemical 3en
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$ou should also tae e5tra measures hen in countries of poor sanitation. For e5ample,
avoid ater and other drins that may not !e safe and avoid food ashed in unsafe ater.
%reast*feeding is also protective. %reast*fed !a!ies are much less liely to develop
gastroenteritis compared to !ottle*fed !a!ies.
$mmuni,ation
As mentioned earlier, rotavirus is the most common cause of gastroenteritis in children.
#here is an effective vaccine against rotavirus. In the it has no !een decided to
routinely vaccinate !a!ies against rotavirus. From Septem!er =:> !a!ies ere offered
drops 3!y mouth4 to prevent rotavirus, along ith their other routine vaccinations. #hese
drops are given at = and > months old.
%ronchopneumonia
%ronchopneumonia is a type of pneumonia. 1neumonia is inflammation of the lungs,
caused !y infection from viruses, !acteria, or fungi. #he infection causes inflammation in
the alveoli 3also non as air sacs4 in the lungs, causing the alveoli to !ecome filled ith
pus or fluid.
#here are to types of pneumonia+ lo!ar and !ronchial. @o!ar pneumonia affects one or
more sections, or lo!es, or the lungs. %ronchopneumonia affects !oth lungs and the
!ronchi. %ronchopneumonia can !e mild or severe, ith viral !ronchopneumonia usually
!eing less severe.
What Causes %ronchopneumonia7
%oth forms of pneumonia are often caused !y coming into contact ith viruses and
!acteria in your day*to*day routine. 6ost cases of !acterial pneumonia are caused !y the
!acteriumtreptococcus pneumoniaH hoever, it is not uncommon for pneumonia to !e
caused !y more than one type of !acteria. ther possi!le culprits include+
• taphylococcus aureus
• Haemophilus influen*ae
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• Klebsiella pneumoniae
6ost cases of viral pneumonia are caused !y the same viruses that cause cold and flu.
According to the 6ayo Clinic, very severe forms of pneumonia are often ac&uired inhospital settings. While they may !e caused !y some of the aforementioned !acteria, this
form of pneumonia can !e caused !y a host of anti!iotic*resistant germs ithin a
healthcare setting 36ayo Clinic, =::4.
Who Is at -is7
Certain groups of people are more at ris for developing !ronchopneumonia. -is factors
include+
• !eing age = or younger
• !eing ) years old or older
• having a lung disease, such as
cystic fi!rosis, asthma, or chronic
o!structive pulmonary disease 3C1(4
• having 2I8KAI(S
• having a chronic disease, such as
heart disease or dia!etes
• having a eaened immune
system, hich may !e caused !y
chemotherapy or use of
immunosuppressive drugs
• !eing on a ventilator
• smoing
• heavy alcohol use
• trou!le coughing or salloing
• !eing malnourished
• What Are the Symptoms7
Symptoms can develop gradually or suddenly. 8iral !ronchopneumonia may initially
present ith flu*lie symptoms, !ut progress in a fe days. Symptoms of
!ronchopneumonia include+
• fever
• cough that !rings up mucus
• shortness of !reath
• chest pain
• rapid !reathing
http://www.mayoclinic.com/health/pneumonia/DS00135/DSECTION=causeshttp://www.mayoclinic.com/health/pneumonia/DS00135/DSECTION=causes
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• seating
• chills
• headache
•muscle aches
• fatigue
• confusion or delirium, especially in older people
#ests and (iagnosis
$our doctor ill !egin !y conducting a physical e5amination. 2e or she may tae your
temperature to loo for a fever. $our doctor ill also use a stethoscope to listen to your
lungs. 2e or she is listening for a !u!!ling or hee
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• A computed tomography 3C#4 scan produces a picture similar to an P*ray !ut in
more detail. #his ill tell your doctor here the infection is occurring in your lungs.
• A sputum culture tests a sample of mucus from your lungs to determine the cause
of the infection.• A !ronchoscopy involves putting a camera don your throat to loo at your
!ronchial tu!es. #his can !e done to determine if there are other factors causing your
!ronchopneumonia.
• Finally, your doctor may order a pulse o5imetry. #his test re&uires you to put a
sensor on your finger and measures the amount of o5ygen in your !lood. #he results of
this test can tell your doctor the e5tent or severity of the infection and its effect on your
a!ility to a!sor! o5ygen.#reatment ptions
8iral !ronchopneumonia normally does not re&uire medical treatment and improves on
its on in one to to ees. Antivirals can help reduce the length of your illness and the
severity of your symptoms.
If you have !acterial !ronchopneumonia, your doctor ill prescri!e anti!iotics to destroy
the !acteria causing the infection. 6ost people feel !etter ithin one to three days after
starting anti!iotics. 2oever, it is important that you finish your entire course of
anti!iotics to prevent the infection from returning.
$our doctor may also suggest a fever reducer or cough medication for !oth viral and
!acterial !ronchopneumonia. #hese medications can help relieve your symptoms, !ut ill
not cure you.
2ome treatment can also help relieve your symptoms. 2ome treatment includes+
• rest
• drining plenty of arm fluids
• using a humidifier
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• drining plenty of ater
$ou may !e admitted to the hospital if your infection is severe and if you meet to or
more of the folloing criteria+
• you are over the age of )
• your !reathing is rapid
• your !lood pressure drops
• you !ecome confused
• you need !reathing assistance
2ospital treatment may include intravenous 3I84 anti!iotics. If your !lood o5ygen levels
are lo, you may !e given o5ygen therapy to help return your !lood o5ygen levels tonormal.
1revention #ips
8accinations can !e very helpful in preventing !ronchopneumonia. 2aving an annual flu
shot can also !e helpful, as influen
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• !ronchopneumonia or bronchial pneumonia or !ronchogenic pneumonia 3not
to !e confused ith lo!ar pneumonia49:; is the acute inflammation of the alls of
the !ronchioles. It is a type of pneumonia characteri;
• #he !ronchopneumonia pattern has !een associated ith hospital*ac&uired
pneumonia, and ith specific organisms such as Staphylococcus
aureus, le!siella, /. coli, and1seudomonas.9?;
• In !acterial pneumonia, invasion of the lung parenchyma !y !acteria produces
an inflammatory immune response. #his response leads to a filling of the alveolar
sacs ithe5udate. #he loss of air space and its replacement ith fluid is called
consolidation. In !ronchopneumonia, or lo!ular pneumonia, there are multiple foci
of isolated, acute consolidation, affecting one or more pulmonary lo!es.
• Although these to patterns of pneumonia, lo!ar and lo!ular, are the classic
anatomic categories of !acterial pneumonia, in clinical practice the types are
difficult to apply, as the patterns usually overlap. %ronchopneumonia 3lo!ular4
often leads to lo!ar pneumonia as the infection progresses. #he same organismmay cause one type of pneumonia in one patient, and another in a different patient.
From the clinical standpoint, far more important than distinguishing the
anatomical su!type of pneumonia, is identifying its causative agent and accurately
assessing the e5tent of the disease.
http://en.wikipedia.org/wiki/Lobar_pneumoniahttp://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-1http://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-1http://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Bronchiolehttp://en.wikipedia.org/wiki/Pneumoniahttp://en.wikipedia.org/wiki/Pulmonaryhttp://en.wikipedia.org/wiki/Bacterial_pneumoniahttp://en.wikipedia.org/wiki/Lobar_pneumoniahttp://en.wikipedia.org/wiki/Lobar_pneumoniahttp://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-isbn0-7216-0187-1-2http://en.wikipedia.org/w/index.php?title=Bronchopneumonia&action=edit§ion=1http://en.wikipedia.org/wiki/Streptococcushttp://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-urlLobar_Pneumonia-3http://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-urlLobar_Pneumonia-3http://en.wikipedia.org/wiki/Hospital-acquired_pneumoniahttp://en.wikipedia.org/wiki/Hospital-acquired_pneumoniahttp://en.wikipedia.org/wiki/Staphylococcus_aureushttp://en.wikipedia.org/wiki/Staphylococcus_aureushttp://en.wikipedia.org/wiki/Klebsiellahttp://en.wikipedia.org/wiki/Klebsiellahttp://en.wikipedia.org/wiki/E._colihttp://en.wikipedia.org/wiki/Pseudomonashttp://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-urlPulmonary_Pathology-4http://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-urlPulmonary_Pathology-4http://en.wikipedia.org/wiki/Parenchymahttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Exudatehttp://en.wikipedia.org/wiki/Pulmonaryhttp://en.wikipedia.org/wiki/Bacterial_pneumoniahttp://en.wikipedia.org/wiki/Lobar_pneumoniahttp://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-1http://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Bronchiolehttp://en.wikipedia.org/wiki/Pneumoniahttp://en.wikipedia.org/wiki/Pulmonaryhttp://en.wikipedia.org/wiki/Bacterial_pneumoniahttp://en.wikipedia.org/wiki/Lobar_pneumoniahttp://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-isbn0-7216-0187-1-2http://en.wikipedia.org/w/index.php?title=Bronchopneumonia&action=edit§ion=1http://en.wikipedia.org/wiki/Streptococcushttp://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-urlLobar_Pneumonia-3http://en.wikipedia.org/wiki/Hospital-acquired_pneumoniahttp://en.wikipedia.org/wiki/Hospital-acquired_pneumoniahttp://en.wikipedia.org/wiki/Staphylococcus_aureushttp://en.wikipedia.org/wiki/Staphylococcus_aureushttp://en.wikipedia.org/wiki/Klebsiellahttp://en.wikipedia.org/wiki/E._colihttp://en.wikipedia.org/wiki/Pseudomonashttp://en.wikipedia.org/wiki/Bronchopneumonia#cite_note-urlPulmonary_Pathology-4http://en.wikipedia.org/wiki/Parenchymahttp://en.wikipedia.org/wiki/Inflammationhttp://en.wikipedia.org/wiki/Exudatehttp://en.wikipedia.org/wiki/Pulmonaryhttp://en.wikipedia.org/wiki/Bacterial_pneumonia
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• 1athology9edit;
• 6ultiple foci of consolidation are present in the !asal lo!es of the human lung,
often !ilateral. #hese lesions are =B? cm in diameter, grey*yello, dry, often
centered on a !ronchiole, poorly delimited, and ith the tendency to confluence,
especially in children.
• A focus of inflammatory condensation is centered on a !ronchiole ith acute
!ronchiolitis 3suppurative e5udate * pus * in the lumen and parietal inflammation4.
Alveolar lumens surrounding the !ronchiole are filled ith neutrophils
3"leuocytic alveolitis"4. 6assive congestion is present. Inflammatory foci are
separated !y normal, aerated parenchyma.
•
• !ronchopneumonia 3also sometimes non as lobular pneumonia :4 is a
radiological pattern associated ith suppurative peri!ronchiolar inflammation and
su!se&uent patchy consolidation of one or more secondary lo!ules of a lung in
response to a !acterial pneumonia.
• #he radiological appearance of !ronchopneumonia is not specific to any single
causative organism, although there are organisms hich classically have a
radiological presentation of !ronchopneumonia and hence the identification of
!ronchopneumonia can provide information regarding the liely aetiological
pathogens . #he most common causative organisms of !ronchopneumonia
are taphylococcus aureus, Klebsiella pneumoniae, Haemophilus
influen*ae, +seudomonas aeruginosa, Escherichia coli, and anaero!es >.
• Epidemiology
• 1neumonia is the most common cause of death due to infectious diseases in the
nited States, ith an incidence ::.K: personsKyear reported in one study ?.
Incidence is higher at the e5tremes of age. %ronchopneumonia is a common
hospital ac&uired infection >.
http://en.wikipedia.org/w/index.php?title=Bronchopneumonia&action=edit§ion=2http://en.wikipedia.org/wiki/Focus_(geometry)http://en.wikipedia.org/wiki/Focus_(geometry)http://en.wikipedia.org/wiki/Human_lunghttp://en.wikipedia.org/wiki/Bronchiolehttp://en.wikipedia.org/wiki/Bronchiolehttp://en.wikipedia.org/wiki/Pushttp://en.wikipedia.org/wiki/Lumen_(anatomy)http://radiopaedia.org/articles/air-space-opacification-1http://radiopaedia.org/articles/secondary-pulmonary-lobulehttp://en.wikipedia.org/w/index.php?title=Bronchopneumonia&action=edit§ion=2http://en.wikipedia.org/wiki/Focus_(geometry)http://en.wikipedia.org/wiki/Human_lunghttp://en.wikipedia.org/wiki/Bronchiolehttp://en.wikipedia.org/wiki/Bronchiolehttp://en.wikipedia.org/wiki/Pushttp://en.wikipedia.org/wiki/Lumen_(anatomy)http://radiopaedia.org/articles/air-space-opacification-1http://radiopaedia.org/articles/secondary-pulmonary-lobule
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• Clinical presentation
• #he presentation of !ronchopneumonia depends on the severity of the disease,
host factors and the presence of complications. %ronchopneumonia may present
ith a productive cough, dyspnoea, pyre5iaKfevers, rigors, malaise, pleuritic painand occasionally haemoptysis ).
• Pathology
• %ronchopneumonia is precipitated !y inhalation 3or rarely haematogenous spread4
of a causative organism. #his results in peri!ronchiolar inflammation, hich can
spread through the pores of ohn to create consolidation throughout an
entire secondary pulmonary lo!ule =.
• Causative organisms of a !ronchopneumonia pattern include >+
• taphylococcus aureus
• Klebsiella pneumoniae
• Haemophilus influen*ae
• +seudomonas aeruginosa
• Escherichia coli
• Anaero!es, such as +roteus species
• 2istologically, multiple small foci of inflammation can !e demonstrated.
/5tensive congestion and dilation of !loods vessels and areas of poorly
circumscri!ed consolidation can !e seen in affected areas D. #hese areas of
inflammation are seperated !y areas of normal lung parenchyma >.
• Radiographic features
• Plain flm
• %ronchopneumonia is characterised !y multiple small nodular or reticulonodular
opacities hich tend to !e patchy andKor confluent. #his represents areas of lung
here there are patches of inflammation separated !y normal lung parenchyma. =.
http://radiopaedia.org/articles/haemoptysis-1http://radiopaedia.org/articles/haemoptysis-1http://radiopaedia.org/articles/pores-of-kohnhttp://radiopaedia.org/articles/secondary-pulmonary-lobulehttp://radiopaedia.org/articles/haemoptysis-1http://radiopaedia.org/articles/pores-of-kohnhttp://radiopaedia.org/articles/secondary-pulmonary-lobule
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• #he distri!ution is often !ilateral and asymmetric, and predominantly involves the
lung !ases D.
• CT - HRCT chest
• 6ultiple foci of opacity can !e seen in a lo!ular pattern, centred at centrilo!ular
!ronchioles. #his may result in a tree*in*!ud appearance. #hese foci of
consolidation can overlap to create a larger hetrogenous confluent area of
consolidation or 'patchor &uilt' appearance .
%ar $nfection vervie*
• Infection can affect the ear canal 3otitis e5terna4, the eardrum, or the middle ear
3otitis media4. 6ost ear in0uries are caused !y pressure changes during directin0ury 3such as a !lo to the ear4 or sport scu!a diving, !ut, a persistently painful
ear may signal an infection that re&uires treatment. %ecause an ear scope
3otoscope4 may not !e availa!le to e5amine the canal and inner ear in remote
locations, starting therapy may !e appropriate until a doctor can !e reached.
%ar $nfection Symptoms
• Symptoms of ear infection include+
• ear pain,
• fullness in the ear,
• hearing loss,
• ringing in the ear,
• discharge from the ear,
• nausea,
• vomiting , and
http://radiopaedia.org/articles/tree-in-bud-appearancehttp://www.emedicinehealth.com/script/main/art.asp?articlekey=58795http://radiopaedia.org/articles/tree-in-bud-appearancehttp://www.emedicinehealth.com/script/main/art.asp?articlekey=58795
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• vertigo.
• Symptoms may follo a respiratory infection such as the common cold.
• (ischarge from the ear canal is often caused !y the infection non as simmer'sear 3otitis e5terna4. A painful ear ith decreased hearing is often the result of otitis
media, an middle ear infection.
%ar $nfection Symptoms
• Symptoms of ear infection include+
• ear pain,
• fullness in the ear,
• hearing loss,
• ringing in the ear,
• discharge from the ear,
• nausea,
• vomiting , and
• vertigo.
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• Symptoms may follo a respiratory infection such as the common cold.
• (ischarge from the ear canal is often caused !y the infection non as simmer's
ear 3otitis e5terna4. A painful ear ith decreased hearing is often the result of otitis
media, an middle ear infection.
%ar $nfection Treatment
• -est+ avoid further scu!a dives, coughing, snee days, may ease ear pressure.
31eople ith a history of high !lood pressure should avoid this product.4
• For infections of the ear canal 3otitis e5terna4+ neomycin 3A*Spore 2C,
Cortisporin, eotricin 2C, cutricin*2C4, polymy5in %,
and hydrocortisone3Cortisporin, tocort, 1oly tic4, to drops in the ear canal four
times per day for five days, may also !e used.
• Flouro&uinolone anti!iotics specifically for the ear are also availa!le 3oflo5acin,
and ciproflo5acin ith de5amethasone4 to treat otitis e5terna and otitis media ith a
perforation or in the presence of ear tu!es.
• If pain occurs, discontinue treatment and see medical attention.
• ral anti!iotics are usually recommended for discharge from the ear, nose, or
mouth. If infection develops, continue anti!iotics for at least five days after all signs
of infection have cleared. #ell your doctor of any drug allergy prior to starting any
anti!iotic. #he doctor ill recommend the right anti!iotic. Some can cause sensitivity
to the sun, so use a sunscreen 3at least S1F :)4. Some patients may !e sensitive to
topical neomycin and have further irritation.
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Role of eustachian tubes
• #he eustachian tu!es are a pair of narro tu!es that run from each middle ear to
high in the !ac of the throat, !ehind the nasal passages. #he throat end of the
tu!es open and close to+
• -egulate air pressure in the middle ear
• -efresh air in the ear
• (rain normal secretions from the middle ear
• Selling, inflammation and mucus in the eustachian tu!es from an upper
respiratory infection or allergy can !loc them, causing the accumulation of fluids
in the middle ear. A !acterial or viral infection of this fluid is usually hat
produces the symptoms of an ear infection.
• /ar infections are more common in children, in part, !ecause their eustachian
tu!es are narroer and more hori
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infections in children !ecause children have more active and relatively larger
adenoids.
Related conditions
• Conditions of the middle ear that may !e related to an ear infection or result in
similar middle ear pro!lems include the folloing+
• titis media *ith effusion is inflammation and fluid !uildup 3effusion4 in the
middle ear ithout !acterial or viral infection. #his may occur !ecause the fluid
!uildup persists after an ear infection has resolved. It may also occur !ecause of
some dysfunction or noninfectious !locage of the eustachian tu!es.
• hronic suppurative otitis media is a persistent ear infection that results in
tearing or perforation of the eardrum.
• %ar infection - acute
• Share on face!oo Share on titter%oomar R Share1rinter*friendly version
• /ar infections are one of the most common reasons parents tae their children to
the doctor. While there are different types of ear infections, the most common is
called otitis media, hich means an inflammation and infection of the middle ear.
#he middle ear is located 0ust !ehind the eardrum.
• An acute ear infection is a short and painful ear infection. For information on an
ear infection that lasts a long time or comes and goes, see+ Chronic ear infection.
• Causes
• #he /ustachian tu!e runs from the middle of each ear to the !ac of the throat.
#his tu!e drains fluid normally made in the middle ear. If the /ustachian tu!e
!ecomes !loced, fluid can !uild up. #his can lead to infection.
http://www.nlm.nih.gov/medlineplus/ency/article/000638.htmhttp://www.addthis.com/bookmark.php?pub=medlineplus&title=MedlinePlus:%20Trusted%20Health%20Information%20for%20Youhttp://www.nlm.nih.gov/medlineplus/ency/article/000638.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000619.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000638.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000638.htmhttp://www.addthis.com/bookmark.php?pub=medlineplus&title=MedlinePlus:%20Trusted%20Health%20Information%20for%20Youhttp://www.nlm.nih.gov/medlineplus/ency/article/000638.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000619.htm
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• /ar infections are common in infants and children, !ecause the /ustachian tu!es
!ecome easily clogged.
• /ar infections may also occur in adults, although they are less common than in
children.
• Anything that causes the eustachian tu!es to !ecome sollen or !loced causes
more fluids to !uild up in the middle ear !ehind the eardrum. #hese causes
include+
• Allergies
• Colds and sinus infections
• /5cess mucus and saliva produced during teething
• Infected or overgron adenoids
• #o!acco smoe or other irritants
• /ar infections are also more liely if a child spends a lot of time drining from a
sippy cup or !ottle hile lying on his or her !ac. 2oever, getting ater in the
ears ill not cause an acute ear infection, unless the eardrum has a hole from a
previous episode.
• Acute ear infections occur most often in the inter. $ou cannot catch an ear
infection from someone else, !ut a cold may spread among children and cause
some of them to get ear infections.
• -is factors for acute ear infections include+
• Attending daycare 3especially those ith more than children4
• Changes in altitude or climate
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• Cold climate
• /5posure to smoe
• Genetic factors 3suscepti!ility to infection may run in families4
• ot !eing !reastfed
• 1acifier use
• -ecent ear infection
• -ecent illness of any type 3loers resistance of the !ody to infection4
• Symptoms
• In infants, the main sign is often irrita!ility and inconsola!le crying. 6any infants
and children ith an acute ear infection have a fever or trou!le sleeping. #ugging
on the ear is not alays a sign that the child has an ear infection.
• Symptoms of an acute ear infection in older children or adults include+
• /ar pain or earache
• Fullness in the ear
• Feeling of general illness
• 8omiting
• (iarrhea
• 2earing loss in the affected ear
• #he ear infection may start shortly after having a cold. Sudden drainage of yello
or green fluid from the ear may mean a ruptured eardrum.
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• All acute ear infections include fluid !ehind the eardrum. $ou can use an
electronic ear monitor, such as /arChec, to detect this fluid at home. #he device
is availa!le at pharmacies, !ut you still need to see your doctor to confirm any
possi!le ear infection.
• Exams and Tests
• #he health care provider ill loo inside the ears using an instrument called an
otoscope. #his may sho+
• Areas of dullness or redness
• Air !u!!les or fluid !ehind the eardrum
• %loody fluid or pus inside the middle ear
• A hole 3perforation4 in the eardrum
• A hearing test may !e recommended if the person has a history of ear infections.
• Treatment
• Some ear infections ill safely clear up on their on ithout anti!iotics. ften,
treating the pain and alloing the !ody time to heal itself is all that is needed+
• Apply a arm cloth or arm ater !ottle to the affected ear.
• se over*the*counter pain relief drops for ears, or as the doctor a!out prescription
ear drops to relieve pain.
• #ae over*the*counter medications for pain or fever, such as i!uprofen or
acetaminophen. (o # give aspirin to children.
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• All children younger than months ith a fever or symptoms should see the
doctor. Children ho are older than months may !e atched at home if they do
not have+
• A fever higher than := OF
• 6ore severe pain or other symptoms
• ther medical pro!lems
• If there is no improvement or symptoms get orse, schedule an appointment ith
your health care provider to determine hether anti!iotics are needed.
• A#I%I#ICS
• A virus or !acteria can cause ear infections. Anti!iotics ill not help an infection
caused !y a virus. 6any health care providers no longer prescri!e anti!iotics for
every ear infection. 2oever, all children younger than months ith an ear
infection are treated ith anti!iotics.
• $our health care provider is more liely to prescri!e anti!iotics if+
• $our child is under age =
• 2as a fever
• Appears sic
• Is not improving over =? to ?D hours
• 6ae sure you or your child taes the anti!iotics every day and finishes all the
medicine, rather than stopping hen symptoms go aay. If the anti!iotics do not
seem to !e oring ithin ?D to = hours, contact your doctor. $ou may need to
sitch to a different anti!iotic.
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• Amo5icillin is commonly the first choice. ther anti!iotics that may !e given are
a
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• Generally, an ear infection is a minor medical pro!lem that gets !etter ithout
complications. 6ost children ill have minor, short*term hearing loss during and
right after an ear infection. #his is due to fluid lingering in the ear.
• -arely, a more serious infection may develop, such as
• 6astoiditis 3an infection of the !ones around the sull4
• 6eningitis 3an infection of the !rain4
• Fluid can remain !ehind the eardrums even after the infection has cleared for
ees or even months.. See also+titis media ith effusion
• ther potential complications include+
• -uptured or perforated eardrum
• Chronic, recurrent ear infections
• /nlarged adenoids or tonsils
• Formation of an a!scess or a cyst 3called cholesteatoma4 from chronic, recurrent
ear infections
• Speech or language delay in a child ho suffers lasting hearing loss from multiple,
recurrent ear infections
• "hen to Contact a #edical Pro$essional
• Call your child's doctor if+
• 1ain, fever, or irrita!ility do not improve ithin =? to ?D hours
• At the start, the child seems sicer than 0ust an ear infection
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• $our child has a high fever or severe pain
• Severe pain suddenly stops hurting ** this may indicate a ruptured eardrum
• Symptoms orsen
• e symptoms appear, especially severe headache, di
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•