Transcript Document 7447376

VIBRIO CHOLERAE
CHOLERA
CHARACTERISTICS
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GRAM-NEGATIVE, COMMA SHAPED
BACILLI
MOTILE – POLAR FLAGELLA
OXIDASE – POSITIVE
CATALASE – POSITIVE
ALKALNE PH ( 6.8 – 10.2)
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SELECTIVE MEDIA ( TCBS )
ALKALINE PEPTON WATER
ANTIGENICITY
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SOMATIC – O ANTIGE
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BIOTYPES: 2
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VIRIO CHOLERAE O-1
NON- O-1 V. CHOLERAE
V. CHOLERAE O-139 ( BENGAL) - 1992
CLASSICAL (MORE SEVERE)
EL-TOR
SEROTYPES: 3
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INABA , OGAWA , HIKOJIMA
HABITAT
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HUMAN
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MAIN SOURCE
NATURALLY
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IN ACQUATIC ENVIRNMENT
PATHOGENESIS
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INGESTION OF CONTAMINATED DRINK
WATER , FOOD
ID - 10 – 10
MULTIPLY IN SMALL INTESTINE , ILEUM
ENTEROTOXIN SIMILAR TO HLET OF E. COLI
ACTIVATE ADENYLATE CYCLASE
CAMP
FLUIDS , EECTROLYTES
DIARRHOEA , VOMITING
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NO INTESTINAL INVASION
NO BACTEREMIA
NO SEPTICAEMIA
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LESIONS ARE PATHOPHYSIOLOGICAL
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CLINICAL PICTURE
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INCUBATIN PERIOD (IP)
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1 – 4 DAYS
ACUTE ONSET
EFFORTLESS VOMITING
PROFUSE WATERY DIARRHOEA (RICE
– WATER )
RAPID DEHYDRATON (10 – 20 L/ DAY)
HYPOVOLAEMIC SHOCK - DEATH
IMMUNITY
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VERY SHORT
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REINFECTIONS(REPEATED ATTACKS)
ARE COMMON
EPIDEMIOLOGY
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HUMAN (ONLY HOST )
POOR ENVIROMENTAL SANITATION
POOR WATER SUPPLY
CONTAMINATED WATER
INDIAN SUBCONTINENT,BANGLADESH
PANDEMICS - EL-TOR BIOTYPE
OUTBREAKS
EPIDEMICS ( PILGRIMAGES )
EL- TOR PROLONGED CARRIAG (ENDEMIC
INFECTION)
LABORATORY DIAGNOSIS
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SPECIMENS :
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MICROSCOPY:
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DARTING MOVEMENT
CULTURE :
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STOOLS
RECTAL SWAB
TCBS ( YELLOW COLONIES)
ALKALINE PEPTONE WATER(6 – 8 h)
SEROLOGICAL IDENTIFICATION
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SLID AGGLUTINATION FOR SEROTYPES
TREATMENT
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REHYDRATION
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REPLACEMENT : FLUID , ELECTROLYTES
ANTIBIOTIC
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TETRACYCLINE
PREVENTION
CONTROL
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PATIENTS
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CONTACTS
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PURE SUPPLY , PROPER TREATMENT
SEWAGE
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PROPHYLAXIS (TETRACYCLINE)
WATER
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ISOLATION , TREATMENT
PROPER DISPOSAL
HEALTH EDUCATION
VACCIN
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NO EFFECTIVE VACCINE AVAILABLE
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KILLED (INJECTION)
LIVE ATTENUATED (ORAL)
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REACTOGENIC
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SHORT IMMUNITY
V.PARAHAEMOLYTICUS
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FOOD POISONING
SEA FOODS (RAW , UNDERCOOKED)
HALOPHILIC (NACL)
GROWS ON TCBS AGAR
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(GREEN COLONIES)
TREATMENT :
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REHYDRATION
CAMPYLOBACTER
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GRAM – NEGATIVE BACILLI
S- SHAPED (SPIRAL)
ACTIVELY MOTILE
OXIDASE POSITIVE
CATALASE POSITIVE
MICROAEROPHILIC ( 5 – 10% CO )
NON CAPSULATED
SPECIES
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C.JEJUNI
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MOST COMMON
THERMOPHILIC (42C – NOT 25C )
HIPPURATE HYDROLYSIS +
SELECTIVE MEDIA (SKIRROW’S )
C. COLI
C. FETUS
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GROW AT 25 C
DISEASES
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ENTERITIS
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80 – 90% ( C. JEJUNI )
C. COLI
SEPTICAEMIA , MENINGITIS,ENDOCAR.
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C. FETUS
IMMUNOCOMPROMISED
EXTREME OF AGE
SOURCE
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INTESTINE OF BIRDS ( CHIKEN )
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DOMESTIC ANIMALS , CATTELE(BEEF)
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UNPASTEURISED MILK
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CONTAMINATED WATER
CHARACTERISTICS
GRAM NEGATIVE SPIRAL SHAPED
BACILLI
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MICROAEROPHILIC
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OXIDASE POSIIVE
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UREASE
POSITIVE
PATHOGENESIS
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INVASIVE DISEASE ( COLON ) – ID:100
DYSENTERIC LIKE ILLNESS
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WATERY DIARROEA (ENTERTOXIN)
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BLLODY DIARROEA
FEVER
ABDOMINAL PAIN
ILEUM
SEPTICAEMIA (IMMUNOCOMPROMISED)
TREATMENT
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REHYDRATION
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ELECTROLYTES
FLUIDS
ANTIBIOTIC :
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ERYTHROMYCIN
CIPROFLOXACIN
GENTAMICIN ( SEPTICAEMIA )
HALICOBACTER
PYLORI
HABITAT
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GASTRIC MUCOSA ( MUCUS LAYER )
TREATMENT
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AMOXACILLIN
METRONIDAZOLE + BISMUTH
SUBCITRATE FOR 1 - 2 WEEK
OR
CLARITHROMYCIN + AMOXACILLIN +
OMEPRAZOLE FOR 1 WEEK
DISEASES
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CHRONIC ACTIVE GASTRITIS
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PEPTIC ULCER
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ASSOCIATED WITH GASTRIC
CARCINOMA
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LYMPHOMA ( MALT )