Infections of the gastro-intestinal tract

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Acute pancreatitis

Case report:

A 36 year old teacher comes with her year-old son into practice and complains of existing for three days by cases that are of aqueous, but also slimy consistency. The symptomatology is when mother and son. Both patients have temperatures up to 39 ° C and diffuse abdominal pain. At the same time they report vomiting on the first day and considerable head, limbs and joints. The mother reported that the two of them had returned from a school trip to a farm and they were there, "fresh from the cow" tasted as a special event not boiled raw milk and drinking. Other participants of this school trip had complained of similar symptoms.
The physical examination of mother and son gives except for a low pressure-sensitive abdomen without unambiguous localized pressure pain no special features. Liver and spleen are not enlarged palpable, the blood pressure is 100/70 mmHg in the Son, with the mother at 125/80 mmHg and the heart rate is still in the high normal range.

Diagnosis:

The medical history and the patient's symptoms suggest a bacterial enteritis out, possibly due to contaminated cow's milk. It is therefore sent a stool sample of two patients in the microbiological institute and requested an investigation on enteritis pathogens such as Salmonella, Campylobacter and Shigella. Two days later, the result is positive for Campylobacter jejuni; on suspicion of contaminated milk with a subsequent group infection is a message to the competent health authority.

Pathogenesis:

Campylobacter jejuni bacteria provide, together with the various Salmonella species are the most common bacterial pathogen of acute infectious enteritis; According to recent announcements by the Robert Koch Institute up to 50% of the enteritis attributable to Campylobacter infections in some states. Campylobacter are Gram-negative, bi- or mono-polar flagellated and beta-lactamase-forming spirilla. They are invasive and produce in its significance not yet clarified toxin. In very rare cases it can lead to complications such as meningitis, sepsis, abscess, pneumonia, Guillain Barré Syndrome, or rider-and post-infectious for arthritis.

Therapy:

Both patients are still in a fairly good state of repair, will be omitted to antibiotic therapy initially. Instead, it is recommended to bed rest and vigorous fluid replacement. An antibiotic treatment with macrolide antibiotics [for example, Azithromycin (ZITHROMAX)] or fluoroquinolones [ciprofloxacin (Cipro, among others) or levofloxacin (Tavanic)] should only in severe course of infection or current severe underlying diseases, such as Antibody deficiency syndrome done.

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