Common pathogens in bacterial gastroenteritis

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  1. Vomiting within Several hours of eating, diarrhea later

    Fried Rice
    Bacillus cereus

    Treatment - Self limited, hydration
  2. Bloody Diarrhea, abdominal pain, fever; rarely Guillain-Barre syndrome

    Poultry (2nd most common foodborne bacterial GI infection
    Camplyobacter jejuni

    Treatment - Hydration, erythomycin, generally self-limited
  3. Nausea, vomiting, diarrhea, flaccid paralysis

    Honey, home canned foods
    Clostridium botulinum

    Treatment - Botulism antitoxin (do not give to infants)
  4. Watery diarrhea, gray pseudomembranes seen on colonic mucosa, possibly bloody

    Antibiotic induced supression of normal colonic flora
    (Clindamycin often causes C. diff
    Clostridium difficile

    Treatment - metronidazole, vancomycin
  5. Wattery diarrhea, vomiting, fever

    Food/water (travelers' diarrhea)
    Escherichia coli (enterotoxigenic)

    Treatment - hydration, self limited
  6. Bloody diarrhea, vomiting, fever, abdominal pain (risk of HUS)

    Ground beef, indirect fecal contamination
    E. coli type 0157:H7 (enterohemorrhagic)

    Treatment - difficult, antibiotics may worsen condition due to bacterial release of endotoxins as they die. Hydration and generally self limited
  7. Vomiting, within several hours of eating; diarrhea later

    Room temperature foods
    Staphylococcus aureus

    Treatment - self limited, hydration
  8. Nausea, abdominal pain, bloody diarrhea, fever, comiting

    Eggs, poultry, milk, fresh produce (most common foodborne bacterial GI infection)
    Salmonella species

    Treatment - Self limited, hydration, immunocompromised patients can be treated with fluoroquinolones (avoid using antibiotics as it increases carrier state)
  9. Fever nausea, vomiting, sever bloody diarrhea, abdominal pain (risk of HUS)

    Food/water: associated with overcrowding
    Shigella species

    Treatment - self limited; hydration, ciprofloxacin, TMP-SMX in severe cases
  10. Copious watery diarrhea, signs of dehydration

    Water, seafood
    Vibrio cholerae (rice water diarrhea)

    Treatment - aggressive hydration as patient can become severely dehydrated and die rather quickly. tetracyclines and doxycycline can decrease disease length
  11. Abdominal pain, watery diarrhea within 24 hours of eating

    Seafood (osters especially)
    Vibrio parahaemolyitcus

    Treatment - Self limited, hydration
  12. Abdominal pain, bloody diarrhea, right lower quadrant pain, fever (can resemble appendicitis)

    Pork, produce, and puppy feces
    Yersinia enterocolitica

    Treatment - Self limited, hydration
Card Set
Common pathogens in bacterial gastroenteritis
Taken from Step Up to USMLE step II
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