Chapter 18

• Gastritis


  Inflammation of the mucosal liningof the stomach
• Enteritis


  Inflammation of thesmall intestines
• Colitis


  Inflammation of thecolon (large intestines)
• Gastroenteritis


  Inflammation of themucosal lining of the stomach and intestine
• Hepatitis


  Inflammation of theliver
• Dysentery


  Low volume, painful,bloody diarrhea
• Dental caries or tooth decay


  Unlike other exterior surfaces, the teeth are hard and do not shed surface cellsallowing accumulation of masses of microorganismsand their products. These accumulations are calleddental plaquesand are involved in the formation of?

  PATHOGEN:Streptococcus mutans
• Periodontal disease


  A term used to describe conditions that are characterized byinflammation degeneration of the structure that supports the teeth.
• Gingivitisis


  Thereversible inflammation of the gingivae or gums, characterized bybleeding of the gumswhile brushing the teeth. This is due toovergrowth of supragingival plaquecausing irritation to the tissues of the gums.
• Periodontitisis


  Achronic gum diseasethat can causebone destruction and tooth loss. It generally causes little discomfort. The gums are inflamed and bleed easily. As the infection progresses, thebone and tissue that supports the teeth are destroyed, leading to loosening and loss of teeth.
• Acute necrotizing ulcerative gingivitis or Vincent's disease


  AKATrench mouthand another common serious infection of the mouth. It is characterized bypain that prevents normal chewingand may be accompanied byhalitosis. The most common organism involved isPrevotella intermedia. The condition is treated by adequate debridement, oxidizing agents, and administration of metronidazole.
• Oral Thrush


  The organism that causes this condition isCandida albicans, a fungus that ispart of the normal flora of the skin, mucous membranes, and gastrointestinal tract. The condition consists ofwhite patches adherent to the oral mucosaand may occur on thetongue, lips, gums, or palate. Factors that predispose the development of oral thrush include endocrine disturbances (e.g., diabetes), prolonged intake of antibiotics, malnutrition, malignancy, immunosuppression, and prolonged use of steroids.
• Mumps (Epidemic Parotitis)


  A highly communicable disease characterized bypainful inflammation of the salivary glands. This infection is caused by the mumps virus, a member of the family Paramyxoviridae and there is only one serotype. Humans are the natural hosts. The disease occurs worldwide, affecting people who have not been vaccinated before the age of 15. Lifelong immunity occurs in persons who have had the disease.
• Citrus juices


  A characteristic increase in parotid pain develops, especially when drinking _____?
• Orchitisis


  Theinflammation of the testis. This complication is significant if it occurs inpost-pubertal malesand if the involvement is bilateral. Bilateral can lead to sterility
• Helicobacter pylori


  The predominant organism involved inchronic gastritis and peptic ulceris? Also, It has two major virulence factors:rapid motility and urease production. Its rapid motility enables it to penetrate the mucus blanket lining the stomach. The urease produced by the organism leads to the production of large amounts of ammonia from urea which leads to the neutralization of gastric acid.

  Gastritis & Peptic Ulcer: is characterized byrecurrent pain in the upper abdomen, specifically around theepigastric area.
• Hepatitis A (HAV)


  This type of hepatitis causesinfectious hepatitis. There is only one serotype. It is transmitted mainly by thefecal-oral route.Sexual transmission is possible but rare. The virus appears in the feces two weeks before the appearance of symptoms.Children are the most frequently infected, and outbreaks may occur. The common source of outbreaks arise fromwater and food contaminated with feces(Street Foods). Recovery time is6 weeks
• Hepatitis B Virus (HBV)


  This type of Hepatitis causesserum hepatitis. It is theonly DNA virusamong the hepatitis viruses. The three main modes of transmission are throughblood, during sexual intercourse, and from mother to newborn during birth or breast feeding. The most efficient method of transmitting the virus is throughinjection into the bloodstream. Majority of patients areasymptomatic.Fulminant infectioncan occur as well as chronic hepatitis which can lead to cirrhosis and death.
• Hepatitis C Virus (HCV)


  This type of Hepatitis causesParenteral hepatitis. It is the predominantcause of non-A, non-B (NANB) hepatitisworldwide and the most common cause ofpost-transfusion hepatitisamong IV drug abusers. It istransmitted primarily via blood. It primarilyinfects hepatocytesand remains inside the hepatocytes throughout. As a result, chronic and persistent hepatitis is the hallmark of infection. Itresembles HBVas far as the ensuing chronic liver disease, cirrhosis, and the predisposition to hepatocellular carcinoma are concerned.Alcoholism greatly enhances the developmentof hepatocellular carcinoma in HCV-infected individuals.

  TREATMENT:Interferon alphaandribavirin
• Hepatitis D Virus (HDV/ Delta Virus)


  This type of hepatitis causesDelta hepatitis. It is an unusual virus in that it is considered as adefective virusfor itcannot replicate on its ownand can only do so in cellsalso infected with HBV. As such, it is considered as aviral parasite. It uses the surface antigen of HBV as its envelope. It is therefore transmitted by the same means as HBV.
• Co-infection


  HDV can occur asco-infectionandsuperinfection. So, between the two choices what type of infection when the patient is infected withboth HDV and HBVat the same time?
• Superinfection


  HDV can occur as co-infection and superinfection. So, between the two choices what type of infection when a personpreviously infected with HBV (carrier)become infected with HDV?
• Hepatitis E Virus (HEV)


  The type of hepatitis that is major cause ofEnteric hepatitis. It is transmitted purely through thefecal-oral route. Clinical manifestations aresimilar to hepatitis A, with the exception of ahigh mortality rate in pregnant women. There is no chronic hepatitis or a prolonged carrier state. Diagnosis is made by excluding HAV and other causes. There isno antiviral drugorvaccineavailable to prevent infection.
• Hepatitis G Virus (HGV/GB Virus C)


  The type of hepatitis thatreplicates within monocytesthen finds its way into the liver where it can cause a chronic type of hepatitis. It is transmitted throughsexual intercourse and blood transfusionand may occur as aco-infection with HIV. It has been noted that patients co-infected with HIV and and this disease have lower mortality rate and have less HIV in their blood than those infected with HIV alone. In vitro studies have shown that this diseasemay interfere with the replication of HIV
• Diarrhea


  Thechange in the normal bowelhabits of an individual, with anincrease in the frequency, fluidity, looseness, and volume of fecesexcreted per day in comparison to the usual fecal output of the individual.In a normal adult. It is the final common pathway ofintestinal responses to many inciting agentsand serves as anadaptive mechanismdeveloped by the body toget rid of noxious material
• Non-invasive diarrhea (Small intestine)


  The results of disruption of the secretory process are due to the toxin released from the bacteria. This is characterized bywatery diarrheaand theabsence of blood or leukocytes in the feces.
• Invasive diarrhea (Colon)


  There isdirect damage to the gastrointestinal tissuesdue to direct invasion by the bacteria. It is characterized by fever,dysentery (blood in stools), andleukocytes in the feces
• Enterotoxigenic E. coli (ETEC)


  A pathogenic group of E.Coli that can cause of"traveler's diarrhea" or "turista"and is an important cause of diarrhea in infants in developing countries. Some strains produce aheat-labile (LT) exotoxinthat causesintense and prolonged hypersecretion of waterand chlorides and inhibits sodium re-absorption
• Enteropathogenic E. coli (EPEC)


  A pathogenic group of E.Coli that can cause ofdiarrhea in infants in developing countries. It was previously associated with outbreaks of diarrhea in nurseries in developed countries. The organismadheres to mucosal cells of the small intestine and causes loss of microvilli. This leads towatery diarrheathat is usually self-limited but can be chronic. Dehydration, electrolyte imbalance, and other complications may cause death so antibiotic therapy is necessary
• Enteroaggregative E. coli (EAEC)


  A pathogenic group of E.Coli thatcauses acute and chronic diarrhea. These are commoncauses of foodborne illness in industrialized countries. This producesST like a toxinand ahemolysin
• Enterohemorrhagic E. coli (EHEC)


  A pathogenic group of E.Coli that produces ashiga-like toxin like that produced by Shigella. The main source of infection isundercooked meat, especially undercooked hamburgers in fast food restaurants. It is associated withhemorrhagic colitis, a severe type of diarrhea that initially presents withbloody diarrhea, vomiting, and severe abdominal pain. It is also associated with hemolytic uremic syndrome, a disease resulting in acute renal failure, hemolytic anemia, and thrombocytopenia (low platelet count). E. coliserotypeO157:H7 is the most common.
• Viral Gastroenteritis


  Acute, self-limited infectious diarrhea which usually involves children, ismost commonly caused by enteric viruses. It may causesevere dehydrationrequiring hospitalization, especially in infants
• Rotavirus


  Themost common viral cause of gastroenteritisin children. Infants and young children are most commonly affected although debilitated adults may also be susceptible. Itdestroys mature enterocytesleading toloss of absorptive functionof the small intestine with net secretion of water and electrolytes
• Norwalk virus


  The virus responsible formajority of cases of non-bacterial food borne epidemic gastroenteritisin all age groups, most especially in adults .The virus causesepidemic gastroenteritiswith watery diarrhea, abdominal pain, nausea, and vomiting. Outbreaks may occur following exposure of multiple individuals to a common source. Majority of outbreaks can be seen in nursing homes.
• Bacterial Enterocolitis (Food Poisoning)


  AKAFood Poisoningas a rule, the incubation period isless than 12 hoursafter ingestion of preformed toxins. Longer incubation period indicates ingestion of live bacteria that must first proliferate before producing the signs and symptoms of infection
• 1. Emetic type - fried rice

  2. Diarrheal type - meat dishes and sauces


  Food poisoning caused by Bacillus cereus has two distinct forms what are they?
• S. aureus


  Theimportant cause of food poisoningand causes food poisoning with theshortest incubation period(30 minutes to 8 hours, average of 2 hours).Enterotoxins are producedwhen the organism grows in food rich incarbohydrates and protein. The major mode of transmission for staphylococcal food poisoning is ingestion of the preformed heat-stable toxin in contaminated food, especially salads, custards, milk products, and processed meat. T
• Clostridium perfringens


  Is a large, rectangular gram positive rod. It is anaerobic and rarely produces spores. An enterotoxin produced by this microorganism is acommon cause of food poisoning.Ingestion of preformed toxin from food contaminated with soil containing the microorganism's spores such asreheated foods like meat dishesis the most common means by which the organism is acquired.
• Vibrio parahaemolyticus


  The most common cause of bacterial gastroenteritisassociated with seafood.
• Enterocolitis


  Characterized byinvasion of the small and large intestines. It begins with nausea and vomiting which progress to abdominal pain and diarrhea (mild to severe, with or without blood). The disease usually lasts a few days and is self-limited. In the U.S., S. enteritidis-serotypeTyphimurium is the most common cause.This is themost common manifestation of salmonella infection.