Enterocolitis

Kleinhaus, S., Weinberg, G. and Gregor, M.B. (1992). Necrotizing enterocolitis in infancy. Surg. Clin. North Am. 72, 261-276. 

Short-gut syndrome (e.g., intestinal artresia, necrotizing enterocolitis, intestinal volvulus, massive resection secondary to inflammatory bowel disease, tumors, mesenteric thrombosis)... 

Birth asphyxia Hypothermia Meconium or amniotic fluid aspiration Necrotizing enterocolitis Respiratory distress syndrome Shock Obstetrics Abortion... 

Severe hemorrhagic pancreatitis Severe necrotizing pancreatitis Necrotizing enterocolitis Diffuse peritonitis Small bowel obstruction Paralytic ileus... 

Song, F., Ito, K., Denning, T.L., Kuninger, D., Papaconstantinou, J., Gourley, W., Klimpel, G., Balish, E., Hokanson, J. and Ernst, P.B. (1999) Expression of the neutrophil chemokine KC in the colon of mice with enterocolitis and by intestinal epithelial cell lines effects of flora and proinflammatory cytokines. Journal of Immunology 162, 2275-2280. 

Kuhn, R., Lohler, J., Rennick, D., Rajewsky, K. and Muller, W. (1993) Interleukin-10-deficient mice develop chronic enterocolitis. Cell75, 263-274. 

The answer is c. (Hardman, pp 996-997r 1145—1146. Ka tzung, p 8455 Metronidazole is often used to treat antibiotic-associated enterocolitis, especially when caused by C difficile. Vancomycin is no longer preferred because it induces selection of resistant staphylococci. Clindamycin is also associated with C difficile colitis, but in another way a higher percentage of patients taking this over other antibiotics develop antibiotic-associated enterocolitis. 

It is a gram-negative, nonsporing, oval-shaped bacterium. It is primarily a zoonotic disease of birds and mammals, with humans as incidental hosts. Often seen in hamsters, guinea pigs, and chinchillas. It has also been associated with enterocolitis and diarrhea in young sheep at pasture that are debilitated from factors such as starvation and cold weather. This is a biosafety level 2 agent. 

Gy All adversely affected with intestinal problems within 30 min 95% dead in 2 weeks from enterocolitis shock 19... 

PMC may result in a spectrum of disease from mild diarrhea to enterocolitis. In colitis without pseudomembranes, patients present with malaise, abdominal pain, nausea, anorexia, watery diarrhea, low-grade fever, and leukocytosis. With pseudomembranes, there is more severe illness with severe abdominal pain, perfuse diarrhea, high fever, and marked leukocytosis. Symptoms can start a few days after the start of antibiotic therapy to several weeks after antibiotics have been stopped. 

Human disease caused by Salmonella generally falls into four categories acute gastroenteritis (enterocolitis), bacteremia, extraintestinal localized infection, and enteric fever (typhoid and paratyphoid fever), and a chronic carrier state. S. typhimurium is the most common cause of salmonellosis. Salmonellosis is a disease primarily of infants, children, and adolescents. 

With enterocolitis, patients often complain of nausea and vomiting within 72 hours of ingestion followed by crampy abdominal pain, fever, and diarrhea, although the actual presentation is quite variable. 

Salmonella can produce bacteremia without classic enterocolitis or enteric fever. The clinical syndrome is characterized by persistent bacteremia and prolonged intermittent fever with chills. Stool cultures are frequently negative. 

Most patients with enterocolitis require no therapeutic intervention. The most important part of therapy for Salmonella enterocolitis is fluid and electrolyte replacement. Antimotility drugs should be avoided because they increase the risk of mucosal invasion and complications. 

These bacteria cause a wide spectrum of clinical syndromes. The majority of cases present with enterocolitis that is mild and self-limiting. Symptoms, generally lasting 1 to 3 weeks, include vomiting, abdominal pain, diarrhea, and fever. A clinical syndrome seen in older children may resemble appendicitis. 

The only absolute contraindications are mechanical obstruction and necrotizing enterocolitis. Conditions that challenge the success of EN include severe diarrhea, protracted vomiting, enteric fistulae, severe GI hemorrhage, and intestinal dysmotility. 

To define the incidence of fractures and rickets that we were encountering in infants who required prolonged parenteral feeding, we reviewed the roentgenograms of a series of preterm infants who developed necrotizing enterocolitis and who required at least four weeks of total parenteral nutritional support (4). These data are recorded in Table I. 

Small birth weight and necrotizing enterocolitis of a fetus resulted from the mother s use of a corticosteroid. 

Other inhibitors of cell wall synthesis. Bacitracin and vancomycin interfere with the transport of pepti-doglycans through the cytoplasmic membrane and are active only against gram-positive bacteria. Bacitracin is a polypeptide mixture, markedly nephrotoxic and used only topically. Vancomycin is a glycopeptide and the drug of choice for the (oral) treatment of bowel inflammations occurring as a complication of antibiotic therapy (pseudomembranous enterocolitis caused by Clostridium difficile), it is not absorbed. 

Wakefield AJ, Anthony A, Murch SH, etal. Enterocolitis in children with developmental disorders. Am J Gastroenterol 2000 95 2285-95. 

These drugs are used for gastrointestinal diseases (cohtis, enterocolitis, severe and chronic dysentery, sepsis, meningitis, pneumonia, infections of the urinary tract, and others caused by P. aeruginosa), when other antibiotics are ineffective. They are effectively nsed in the form of ointments for treating a few forms of eczema, boils, hidradenitis, and other skin diseases. 

Use caution when bisphosphonates are given to patients with active upper Gl problems (such as dysphagia, esophageal diseases, gastritis, duodenitis, or ulcers). Etidronate therapy has been withheld from patients with enterocolitis because diarrhea is seen in some patients, particularly at higher doses. 

Children younger than 2 years of age because of greater variability of response hypersensitivity to diphenoxylate or atropine obstructive jaundice diarrhea associated with pseudomembranous enterocolitis or enterotoxin-producing bacteria. 

Diarrhea Diphenoxylate may prolong or aggravate diarrhea associated with organisms that penetrate intestinal mucosa (ie, toxigenic Escherichia coli, Salmonella, Shigella) or in pseudomembranous enterocolitis associated with broad-spectrum antibiotics. Do not use diphenoxylate in these conditions. In some patients with acute ulcerative colitis, diphenoxylate may induce toxic megacolon. Fluid/Electrolyte balance Dehydration, particularly in younger children, may... 

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