MMIC PBL Blog Post 1

Particulars of Patient:
Name: Kwan Siew Yan
Sex: Female
Age: 29 years

Clinical Diagnosis:
Complaints: Diarrhea
Diagnosis: Entercolitis: Inflammation of large and small intestines
Antibiotic treatment: NIL

Possible organisms:
1) Vibrio species:
· V. parahaemolyticus
2) Campylobacter species:
· C. jejuni
3) Bacilius species:
· B. cereus
4) Clostridium species:
· C. difficile
· C. perfringens
5) Escherichia species:
· Enteroinvasive E. coli (EIEC)
6) Salmonella species
· S. enteritidis
· S. typhimurium
7) Shigella species
· S. dysenteriae
· S. flexneri
· S. boydii
· S. sonnei

1) Vibrio species
V. parahaemolyticus
Definition: Curved, rod-shaped, gram-negative bacterium that is found in saltwater
Possible disease: Gastroentritis
Symptoms: Watery diarrhea, nausea, vomiting, abdominal cramping, fever and chills
Cause: Ingestion of bacteria in raw or uncooked seafood
Treatment: Not necessary since the disease is self-limiting. The most common ones are Tetracycline and erythromycin.

2) Campylobacter species
C.jejuni
Definition: Curved, rod-shaped, gram-negative bacterium that produces a cholera-like enterotoxin
Possible disease: Gastroentritis
Symptoms: Diarrhea, abdominal pain and fever
Cause: Ingestion of incorrectly prepared meat and poultry and drinking of contaminated water
Treatment: No antibiotics are given as the disease is self-limiting. Erythromycin may be given for serious cases.

3) Bacillus species
B. cereus
Definition: Rod-shaped, gram-positive bacterium that can produce protective endospores in addition to enterotoxin
Possible disease: Foodborne illnesses
Symptoms: Diarrhea, gastrointestinal pain, nausea and vomiting
Cause: Ingestion of improperly cooked food or improperly refrigerated food
Treatment: No specific treatment is needed. Vancomycin and gentamycin may be given for symptomatic treatment.

4) Clostridium species
C. difficile
Definition: Rod-shaped, spore-forming, gram-positive bacterium that are capable of producing enterotoxin and cytotoxin
Possible disease: Pseudomembraneous colitis
Symptoms: Diarrhea and abdominal pain
Cause: Ingestion of antibiotics that alters the normal intestinal flora, causing the bacterium to grow and produce toxins.
Treatment: No treatment needed for mild cases. Anti-clostridial agents like metronidazole may be used.

C. perfringens
Definition: Rod-shaped, spore-forming, gram-positive bacterium that produces heat-resistant enterotoxin
Possible disease: Foodborne illnesses
Symptoms: Diarrhea, gastrointestinal pain
Cause: Ingestion of poorly prepared meat and poultry
Treatment: Only symptomatic treatment is given.

5) Escherichia species
Enteroinvasive E. coli (EIEC)
Definition:
Possible disease: Human diarrheal illness
Symptoms: Watery diarrhea, abdominal cramping and fever
Cause: Ingestion of contaminated food and water
Treatment: The infection can be treated with TMP-SMX (trimethoprim-sulfamethoxazole).

6) Salmonella species
S. enteritidis
S. typhimurium
Definition: Rod-shaped, gram-negative bacteria infects without causing visible disease
Possible disease: Gastroenteritis
Symptoms: Diarrhea, fever and abdominal cramps
Cause: Ingestion of foods that are not properly cooked
Treatment: No antibiotic treatment is required as the disease is self-limiting.

7) Shigella species
S. dysenteriae
S. flexneri
S. boydii
S. sonnei
Definition: Rod-shaped, non-spore forming, gram-negative bacteria, closely related to Salmonella and Escherichia coli species
Possible disease: Human diarrheal illness
Symptoms: Diarrhea, fever and stomach cramps
Cause: Ingestion of contaminated food, poor hygienic practices
Treatment: No treatment is needed in mild cases. Ampicillin may be used for severe ones.

Tham Wan Jin June
TG02
0505073G