Invasive Escherichia coli enteritis
Introduction
Introduction to invasive Escherichia coli enteritis Intestinal invasive Escherichia coli infection, alias: intestinal invasive Escherichia coli infection, intestinal invasive Escherichia coli infection, invasive E. coli enteritis. Enteroinvasive E. coli (EIEC) was first reported in Japan in 1967 for large children and adults with diarrhea-like diarrhea, often mistaken for bacillary dysentery. It is mainly caused by illness in large children and adults. The clinical manifestations are fever, abdominal pain, diarrhea, urgency, and pus and bloody stools. Symptoms and dysentery are not easily identified. It is mainly caused by illness in large children and adults. Newborns have a poor susceptibility to this bacterium. There have been no reports of outbreaks among small babies. There have been cases of prevalence in schools, military units, associations and hospitals, mostly sporadic cases. basic knowledge Probability ratio: Susceptible people: no specific population Mode of infection: non-infectious Complications: bacteremia, hemolytic uremic syndrome, arthritis
Cause
Invasive Escherichia coli enteritis
Causes
Enteric infectious diseases caused by EIEC. EIEC is a group of diarrhea-causing Escherichia coli isolated from the stool of "dysentery" patients in 1967. EIEC and Shigella have similar biochemical characteristics, no power, no fermentation of lactose or slow fermentation, common antigen, all invasive pathogenic bacteria, also known as dysentery-like Escherichia coli, can invade epithelial cells, and Among them, growth and reproduction cause an inflammatory reaction. It is necessary to pay attention to the identification of the two, and the identification medium has a citrate medium and a sodium acetate medium. Common O serotypes are: O28, O29, O32, O112, O124, O136, O143, O144, O152, O164, O167 and the like. EIEC does not produce enterotoxin, which mainly invades the colon and forms intestinal wall ulcers. It is highly viral, and it can be caused by only 10 to 100 bacteria. Polluted water and food can cause outbreaks, and can also be spread by contact to form sporadic cases. Adults and children can be ill.
Pathogenesis
EIEC invades intestinal mucosal epithelial cells, which release endotoxin after the death of bacteria, destroying cells to form inflammation and ulcers, causing diarrhea. Less common in clinical practice, mainly infringing older children and adults. The clinical manifestations are similar to dysentery
Prevention
Invasive Escherichia coli enteritis prevention
Intestinal invasive Escherichia coli infection is a self-limiting disease in most cases and healed in more than 1 to 2 weeks. The prognosis is related to the following factors:
1 year old, frail, infants and patients with low immune function, many complications, serious prognosis.
2 toxic bacillary dysentery has a high mortality rate, especially respiratory failure.
3 Shigella dysenteriae type I caused more serious symptoms, while Fusarium is prone to chronic, drug-resistant strains affect the efficacy.
4 The use of appropriate antibacterial drugs plays an important role in the elimination of infection. Improper medication, inadequate treatment, and untimely treatment all affect the efficacy.
Complication
Invasive Escherichia coli enteritis complications Complications bacteremia hemolytic uremic syndrome arthritis
complication
Intestinal complications of invasive Escherichia coli infection are rare.
1. Bacteremia: mainly seen in children, with malnutrition, sickle cell anemia and immunocompromised patients. There are more than 100 cases in foreign countries, and there are also a few cases reported in China. The symptoms of bacteremia are more serious, and the mortality rate is as high as 46%. Bacteremia is more common in 1-2 days after onset, antibiotic treatment is effective.
2, hemolytic uremic syndrome: mainly seen in Shigella infection of Shigella. Some cases begin with a leukemia-like reaction, followed by hemolytic anemia and DIC. Some cases have acute renal failure, renal arteries have thrombosis and renal cortical necrosis, fibrin deposition in the glomeruli and arterial wall, about half of the cases are positive for sputum test, and most cases are positive for immune complexes in serum. Endotoxemia may be associated with the disease. However, endotoxemia caused by other bacteria has no similar performance. The prognosis of this disease is serious.
3, arthritis: more than 2 weeks after the fungus, may be caused by allergic reactions, mainly involving large joints, can cause knee and ankle joint swelling, exudate. There is an antibody that binds Shigella in the joint fluid, and the serum anti-O" titer is normal. Treatment with hormones can be quickly relieved.
Symptom
Invasive Escherichia coli intestine symptoms Common symptoms Abdominal pain, acute diarrhea, feces, pus and fever, accompanied by abdominal pain,...
The clinical manifestations are fever, abdominal pain, diarrhea, urgency, and pus and bloody stools. Symptoms and dysentery are difficult to identify. The diagnosis must be positive for EIEC serum agglutination test, and Escherichia coli obtained from stool culture is also positive for guinea pig corneal test. Treatment of the same bacteria, antibiotic treatment for severe cases.
Examine
Examination of invasive Escherichia coli enteritis
an examination:
1. The Escherichia coli obtained from stool culture was also positive for the guinea pig cornea test.
2. Fecal bacteria culture.
3, it is routine.
4, blood routine.
Diagnosis
Diagnosis and diagnosis of invasive Escherichia coli enteritis
diagnosis
Determining the diagnosis must be positive for the EIEC serum agglutination test.
Differential diagnosis
Clinical attention is distinguished from bacillary dysentery.
