Cholera and other bacterial infections

Cholera is an infection of the small intestine caused by the bacterium Vibrio cholerae.

Cholera bacteria produce a toxin that triggers the secretion of large amounts of fluid rich in salts and minerals in the small intestine. Because the bacteria are sensitive to stomach acid, the disease is more common in people who lack it. In areas where cholera often occurs (endemic), incomplete natural resistance gradually appears among the population.

Image: Cholera occurs in Asia, the Middle East, Africa, and Latin America.

Cholera is transmitted by consuming water, seafood, and any food contaminated by infected people's secretions. It occurs in parts of Asia, the Middle East, Africa, and Latin America, where outbreaks tend to occur during the year's warm months, and the infection is most common among children. In other parts of the world, epidemics can break out at any time of the year and affect all age groups equally. Other types of Vibrio bacteria can also cause infections in humans. They are reflected by diarrhea, which is less severe than cholera.

Symptoms and diagnosis

The disease appears one to three days after the bacteria is infected. It manifests itself in different forms: the patient can only have mild, uncomplicated diarrhea, or he can also die. In some infected people, the disease does not appear at all.

The disease usually begins suddenly, without pain, with liquid stools and vomiting. In severe cases with liquid stools, the patient may lose more than a quarter of body fluid in an hour, but the fluid loss is usually much less. Due to the critical loss of water and salt, severe dehydration occurs in severe cases, reflected by pronounced thirst, muscle cramps, general weakness, and deficient urine production.

Such abundant fluid loss from the tissues results in bruised eyes and severely wrinkled skin of the fingers. If left untreated, the imbalance between blood volume and increasing salt concentration can lead to kidney failure, shock, and coma. Symptoms usually go away within three to six days. In most cases, the microorganism is removed from the body within two weeks, but some patients remain permanent carriers.

The diagnosis of cholera can be confirmed by isolating the bacteria from a rectal swab or a fresh stool sample. Since the bacterium Vibrio cholerae does not grow in the classic culture medium of mud, we must require unique culture mediums for these microorganisms.

Prevention and treatment

The primary measures to eradicate cholera are cleaning water reservoirs and adequately disposing human sewage. We only use boiled water and do not eat poorly cooked vegetables or undercooked fish and shellfish. The cholera vaccine only partially protects against infection, so it is generally not recommended. Timely administration of the antibiotic tetracycline can prevent transmission of the infection to people living in the same household as people infected with cholera.

Image: Severe cases require rapid treatment with intravenous fluids and antibiotics.

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The essence of the treatment is the rapid replacement of lost body fluids, salts, and minerals. For severely dehydrated patients who cannot drink, fluids are replaced intravenously. During an epidemic, patients can be replaced with liquid through a tube placed through the nose into the stomach. After replacing the lost fluid that caused dehydration, we must also replace the fluid that the body lost due to intestinal secretions and vomiting. When the patient is no longer vomiting, and his appetite is restored, he can start eating solid food.

Early treatment with tetracycline or other antibiotics (e.g. (such as ciprofloxacin) destroys the bacteria and usually stops diarrhea within 48 hours. More than 50 percent of untreated severe cholera patients die. The mortality rate of patients who received adequate fluid replacement in time is less than one percent.

Infections caused by bacilli

Bacilli are a type of bacteria with a characteristic rod shape. According to their shape, round (cocci), rod-shaped (bacilli) and spiral bacteria (spirochetes) are distinguished. Its rigid, complex, multi-layered cell wall gives the bacterium its final shape. In addition to classification by shape, most bacteria, including bacilli, are also classified according to color according to the so-called i. Gram staining, which is used in laboratory tests. Bacteria that turn blue are Gram-positive, and those that turn pink are Gram-negative.

The classification of bacteria into Gram-negative and Gram-positive coincides with certain characteristics of the bacteria's outer wall, the types of infections they cause, and the types of antibiotics that destroy the bacteria.

Infections with Gram-positive bacilli

In the world of bacteria, Gram-positive bacteria are in the minority. They are generally sensitive to penicillin and tend to become resistant to it slowly. Some Gram-positive bacteria (e.g., certain streptococci) can penetrate deep into tissues, while others produce extremely toxic substances (e.g., Clostridium botulinum toxins). Infections caused by Gram-positive bacilli are erysipeloid, listeriosis, and anthrax.

Gram-negative bacteria are characterized by the double wall surrounding the bacterial cell. All bacteria have an internal cell wall, but Gram-negative bacteria also have an external wall that prevents certain drugs and antibiotics from entering the cell. This is partly why Gram-negative bacteria are generally more resistant to antibiotics than Gram-positive bacteria.

Video content: The story of cholera.

The outer wall of Gram-negative bacteria is rich in molecules called lipopolysaccharides. If Gram-negative bacteria invade the bloodstream, lipopolysaccharides can trigger a chain of different conditions, including high body temperature and a drop in blood pressure. Therefore, we believe that lipopolysaccharides are some endotoxins.

Gram-negative bacteria easily exchange genetic material (DNA) between individual strains of the same species and even between different species. This means that a Gram-negative bacterium that either genetically changes (mutates) or adopts the genetic material responsible for antibiotic resistance can later share its DNA with another strain of bacteria that can also become resistant.

Erysipeloid

Erysipeloid is a slowly developing skin infection caused by the bacterium Erysipelothrix rhusiopathiae. Although Erysipelothrix rhusiopathiae initially grows on dead and decaying matter, it can also infect carrion, shellfish, fish, birds, and mammals. People usually become infected through an injury at the workplace, most typically through a cut when handling animal material (e.g., meat, poultry, fish, bones).

Symptoms and diagnosis

A week after infection with the bacterium Erysipelothrix rhusiopathiae, a purple-red, firm change is formed above the skin level at the site of the injury. Itching, burning, and swelling around the affected area also occur. The most common site of infection is the hand, which is challenging to use due to swelling. The affected area is slowly expanding.

Usually, the infection goes away even without treatment, but the patient has had pain in the limb for two to three weeks, so he cannot use it. In exceptional cases, the infection spreads through the blood to the joints or heart valves. The symptoms and circumstances in which the infection occurred help the doctor establish the diagnosis. The diagnosis can be confirmed by culture of a skin sample scraped from the outer edge of the affected area.

Treatment

The infection can be cured with a single dose of penicillin injected into a vein or with a one-week intake of erythromycin. If the joints or heart valves are infected, longer-term intravenous antibiotic treatment is required.

Listeriosis

Listeriosis is an infectious disease caused by Listeria monocytogenes. It causes different symptoms - depending on the infection site and the infected person's age. Listeria bacteria are widespread throughout the world. They are found in nature and the intestines of birds, spiders, crustaceans, and mammals, but not in humans. In humans, listeriosis can affect almost all organs. Newborns, people over 70 years old, and those with a weakened or defective immune system are most exposed to it. Most infections occur in July and August. We usually get infected by eating contaminated dairy products or raw vegetables.

Symptoms and diagnosis

In adults, listeriosis most often occurs in the form of meningitis, i.e., infection of brain and spinal cord abscesses (meninges). Twenty percent of patients develop a brain abscess. Meningitis is manifested by fever and a numb nape. Confusion, coma, and death can occur if the patient is not treated. Listeria can also cause an eye infection that manifests as redness and pain. It can spread to the lymph nodes, blood, and meninges. It rarely infects the heart valves and causes heart failure.

The doctor suspects listeriosis based on the patient's symptoms. The diagnosis is confirmed by laboratory identification of the microorganism in a tissue or body fluid culture. The level of antibodies against Listeria bacteria can also be determined in a blood sample.

Treatment

Ampicillin is the drug of choice for treating listeriosis. If the disease has affected the heart valves, another antibiotic, such as tobramycin or gentamicin, is added to the penicillin. Eye infections are treated with erythromycin.

Anthrax

Anthrax (black pimple, spleen graft) is caused by Bacillus anthracis, which infects the skin, lungs, and digestive tract. Anthrax is a highly contagious disease that can be fatal. Dormant bacteria (spores) can live for decades in the soil and products of animal origin (e.g., in wool). A person usually becomes infected through the skin but can also eat infected meat or inhale spores or bacteria.

Symptoms and diagnosis

The disease appears from twelve hours to five days after exposure to the bacteria. After a skin infection, a small red-brown spot appears, which spreads and swells at the edges. A bubble forms, which hardens and bursts in the middle, and a clear liquid flows out. A black scab then forms at the site of the blister. Lymph nodes may swell in the affected area, and the patient feels terrible and sometimes complains of muscle pain, headache, fever, nausea, and vomiting.

Pulmonary anthrax is caused by inhaling spores of the anthrax bacteria. The spores multiply in the lymph nodes near the lungs, which become punctured and bleed, spreading the infection to nearby areas of the chest. The infected fluid is retained in the lungs and the space between the lungs and the chest wall.

Image: pulmonary anthrax is caused by inhalation of anthrax bacteria spores.

At first, the symptoms are mild and similar to the flu. Then, the body temperature begins to rise, and within a few days, breathing problems appear, followed by shock and coma. Infection of the brain and brain abscesses (meningoencephalitis) can also occur. This form of anthrax is almost always fatal, even if treatment is started quickly.

Anthrax in the digestive tract is not shared. The bacteria grow in the intestinal wall, releasing a toxin that causes massive bleeding and tissue death. If the infection spreads to the bloodstream, it can be fatal.

Information about the patient's contact with animals helps the doctor determine the correct diagnosis. To diagnose pulmonary anthrax, a doctor needs a sputum sample for culture. However, we cannot always identify the bacteria in the laboratory. Sometimes, we start treating the patient even when anthrax is suspected, even before laboratory confirmation of the causative agent.

Prevention and treatment

People at high risk of anthrax infection, such as veterinarians, laboratory technicians, and textile industry workers who process animal hair, can be vaccinated. Cutaneous anthrax is treated with penicillin injections or with tetracycline or erythromycin. In the case of lung infection, penicillin is prescribed as an intravenous injection. Other antibiotics can also be used. The use of corticosteroids can limit inflammation in the lungs. If treatment is delayed (usually because the diagnosis is not made in time), the patient will very likely die.

Haemophilus infections

Hemophilus infections are infectious diseases caused by the bacteria Hemophilus. Hemophilus bacteria are found in the upper respiratory tract of children and adults but rarely cause illness. The strain that most often causes the disease is Hemophilus influenzae.

It can cause meningitis (infection of the brain and spinal cord), bacteremia (infection in the bloodstream), septic arthritis (joint infection), pneumonia, bronchitis, otitis media (middle ear infection), conjunctivitis (infection of the conjunctiva), sinusitis and acute epiglottitis (infection of the flap just above the vocal cords). These infections are common in children but can also occur in adults.

Some examples of Gram-negative bacilli:

Bartonella
Proteus
Brucella
Providencia
Campylobacter
Pseudomonas
Enterobacter
Salmonella
Escherichia
Serratia
Francisella
Shigella
Hemophilus
Vibrio
Klebsiella
Morganella
Yersinia

Other Hemophilus bacteria can cause respiratory tract infections, heart (endocarditis), and brain abscesses. Hemophilus ducreyi causes the sexually transmitted disease soft chan-kar. Routine vaccination against Hemophilus influenza type B, which has been taking place in Slovenia since the fall of 1999, prevents meningitis, which this microorganism can cause.

Brucellosis

Brucellosis (Maltese disease, Mediterranean fever) is an infectious disease caused by the Brucella bacterium. It can be contracted by direct contact with the secretions of infected animals, by drinking unpasteurized cows, sheep's, or goat's milk, or by consuming dairy products (e.g., butter and cheese) that contain live brucella. Human-to-human transmission is rare. The disease occurs most often in rural areas, but meat processors, veterinarians, farmers, and livestock breeders can become infected at work.

Symptoms and complications

Symptoms appear from five days to several months (usually two weeks) after infection with the bacteria and are very different, at least in the initial period. The disease can start suddenly with chills and fever, a severe headache, pain, and a lousy po. Sensation and sometimes with diarrhea. But it can start more insidiously with mild malaise, muscle aches, headache, and neck pain.

As the disease progresses, a fever between 40° and 40.5°C appears in the evening. The temperature slowly decreases and returns to a typical or almost average value in the morning with pronounced sweating.

Intermittent fever lasts from one to five weeks. It is followed by a two—to fourteen-day period of milder symptoms or a period without them. Then, the fever returns. This disease pattern may occur only once, but some people have chronic brucellosis, in which periods of fever and improvement alternate for months or years.

Video content: Brucellosis - causes, signs and symptoms, diagnosis and treatment.

This first period of illness is usually followed by severe constipation, loss of appetite, weight loss, abdominal and joint pain, headache, back pain, general weakness, irritability, insomnia, depression, and psychological instability. Later, the lymph nodes, spleen, and liver may become enlarged. Patients with brucellosis usually recover after two to three weeks of illness.

Complications are rare. Infection of the heart, brain, and brain tumors, inflammation of the nerves, testicles, gall bladder, liver, and bones can occur. Chronic brucellosis makes the patient sick for a long time, but the disease is rarely fatal.

Diagnosis

The doctor thinks of brucellosis when the patient has been exposed to infected animals or products of animal origin, e.g., unpasteurized milk. Brucellosis is proven with the help of a blood sample or, more rarely, a sample of cerebrospinal fluid, urine, or tissue from an infected person, which is sent to a laboratory for culture. A high level of antibodies against the causative agent can be detected in the blood with blood tests.

Prevention and treatment

Infection with Brucella bacteria can be prevented by not consuming unpasteurized milk and improperly aged cheese. People who work with animals or carcasses should wear safety glasses and rubber gloves and cover any skin wounds. Removing infected animals and vaccinating young, healthy animals also help prevent the spread of infection.

If brucellosis is treated with only one antibiotic, the disease often recurs. Therefore, we often prescribe a combination of antibiotics. Doxycycline or tetracycline, together with streptomycin or gentamicin injection given once daily, reduce the risk of relapse. Trimethoprim-sulfamethoxazole and streptomycin or rifampin are prescribed for children under eight, as tetracyclines can damage teeth. In severe cases, we use corticosteroids, e.g., prednisone. A patient with severe muscle pain usually also needs a potent pain reliever, e.g.codeine.

Tularemia

Tularemia (rabbit fever) is a bacterial infectious disease caused by the microorganism Francisella tularensis.

Francisella tularensis is a microorganism that can be contracted by eating the meat of an infected animal or touching an infected animal. The bacterium penetrates intact skin. The disease can also be transmitted by inhaling airborne animal tissue containing the microorganism and by the bite of an infected tick or similar blood-sucking carrion.

The infection most often occurs in hunters, butchers, farmers, furriers, and laboratory workers. In winter, people usually become infected by contact with wild rabbits (mainly during skinning). In the summer, however, infection most often occurs through contact with infected animals or due to the bite of infected ticks and similar critters. Tularemia is rarely caused by eating undercooked meat from an infected animal or drinking contaminated water. Person-to-person transmission has not been proven.

Forms of tularemia

We know four forms of tularemia. The most common form (ulceroglandular tularemia) causes ulcers on the hands and fingers and swollen lymph nodes on the affected side of the body. Another form (oculoglandular tularemia) affects the eye, which becomes red and swollen, and the lymph nodes also swell. It most likely occurs when an infected finger touches the eye.

In the third form of the disease (glandular tularemia), the lymph nodes swell, but ulcers do not form, so we think the infection's source is most likely an ingested bacterium. The fourth form of the disease (typhoidal tularemia) is characterized by a high body temperature, abdominal pain, and the patient's disability. If the infection spreads to the lungs, pneumonia may develop.

Symptoms

The disease begins suddenly, within one to ten days (usually two to four days) after contact with the bacteria. Initially, headache, chills, nausea, vomiting, fever up to 40°C, and marked exhaustion occur. Severe weakness, recurrent chills, and profuse sweating occur. After 24 to 48 hours, an inflammatory blister forms at the entry site (usually on a finger, hand, eye, or on the roof of the mouth).

It is not observed in glandular and typhoid forms of tularemia. The blister festers, breaks open, and causes an ulcer. Usually, only one ulcer appears on the hands or feet, but there are usually several in the mouth or eye. Most often, only one eye is affected. The lymph nodes around the ulcer swell and may fester, and later, pus may flow from them.

Delirium may occur in patients with tularemic pneumonia. Pneumonia can only cause milder symptoms, e.g., dry cough with burning pains in the center of the chest. A pink rash may spread over the skin at any time during the illness.

Diagnosis

The doctor thinks of tularemia when, after a tick bite or any fleeting contact with a wild mammal, especially a rabbit, the patient suddenly develops symptoms and ulcers typical of the infection. Laboratory worker infections usually affect only lymph nodes or lungs and are very difficult to identify. The disease is proven by isolating the bacteria from ulcers, lymph nodes, blood, or sputum samples.

Treatment

Tularemia is treated for five to seven days with antibiotics, which patients take or receive as injections. We place wet compresses on the ulcers, which we change often to prevent the spread of infection and swelling of the lymph nodes. Large boils need only be drained in rare cases. With ocular tularemia, warm compresses on the affected eye and glasses with tinted lenses help somewhat.

Image: we know four forms of tularemia.

Patients with severe headaches are prescribed pain relievers, e.g., codeine. Patients who are treated chiefly survive, but about 6 percent of untreated patients die. Death usually occurs as a result of uncontrolled infection, pneumonia, infection of the brain opening (meningitis), or infection of the peritoneum (peritonitis). Recurrences of the disease are rare; they may appear when treatment has been insufficient. After recovering from tularemia, lifelong resistance to re-infection remains.

Plague

Plague (Black Death) is a severe infectious disease caused by the bacterium Yersinia pestis. The bacteria that cause plague first infects wild rodents such as rats, mice, squirrels, and steppe dogs. In the past, large-scale plague epidemics, e.g., the Black Death in the Middle Ages, killed many people. Historically, plague outbreaks have been limited to individual cases or small groups of people.

Plague is transmitted from infected žHumans are usually fleas. Transmission from person to person can occur through coughed or sneezed droplets containing bacteria. It is also possible to transmit the infection from domestic animals, especially cats, either by a flea bite or by inhaling infected droplets.

Symptoms and diagnosis

In bubonic plague, symptoms appear a few hours to twelve days after exposure to the bacteria but usually within two to five days. The disease begins suddenly with chills and a fever of up to 40 °C. Heartbeat after. Costs are accelerated, and blood pressure decreases. With the onset of fever or soon after, the lymph nodes (buboes) swell, often very painful to pressure, firm, and surrounded by doughy swelling.

The skin over them is tense and red but cool. As a rule, patients become restless, delirious, confused, and unbalanced. The doctor can quickly feel the enlarged liver and spleen. The lymph nodes may fester and discharge pus in the second week of the disease. More than 60 percent of untreated patients die. In most cases, death occurs between the third and fifth day of the illness.

Pneumonic plague is an infection of the lungs with the bacteria that cause plague. Two to three days after exposure to the bacteria, the disease starts with high body temperature, chills, rapid heart rate, and often a very severe headache. Within twenty-four hours, a cough appears. At first, the sputum is clear, then it becomes frothy, sometimes bloody, and finally uniformly pink or bright red. Accelerated and labored breathing often occurs. Without treatment, the disease dies 48 hours after the onset of symptoms.

Even in septicemic plague, the bubonic form spreads into the bloodstream. Death may occur before other symptoms of bubonic or pneumonic plague appear. Pestis minor is a mild form of the plague, typical of geographical areas where the disease often occurs (endemic). Swollen lymph nodes, fever, headache, and exhaustion usually disappear within a week. The diagnosis is made by isolating the bacteria from a blood sample, sputum, or lymph node.

Prevention and treatment

The essence of preventing the spread of the plague is exterminating rodents and using protective agents against carrion bites. Vaccine against the plague exists, but vaccination is not necessary for most people traveling to places where the plague occurs, vaccination is not necessary. If contact with the plague is possible, they can take preventive doses of tetracycline. As soon as the doctor suspects the patient has the plague, he begins treatment.

In the septicemic or pulmonary form of the disease, treatment must be started within the first twenty-four hours of the disease. With timely treatment, the mortality rate of the disease is reduced to less than 5 percent. Many antibiotics are effective in treatment. Patients with pneumonic plague must be isolated, which is unnecessary for the bubonic form of the disease. Persons in contact with a pneumonic plague patient must be carefully observed or treated.

Cat Scratch Disease

Cat-scratch disease is an infection with the bacterium Bartonella henselae at a site scratched by a cat. When a person is scratched by a cat infected with Bartonella henselae, it causes an infection of the blood vessel wall. Cats usually show no signs of illness.

Symptoms

From three to ten days after a cat scratch, a red, scab-like blister, up to 6.5 cm in diameter, appears at the injury site, which rarely festers (pustule). The regional lymph nodes swell, become firm, and are rarely painful to the touch. Later, they decay, and pus may start to flow out. The patient feels unwell, loses appetite, and has a fever or headache. In about 10 percent of those infected, signs of the disease can also appear in the eyes, causing visual disturbances or swelling of the brain, which causes a headache or loss of consciousness.

Skin and lymph node changes disappear after two to five months. The cure is complete. In patients with AIDS, the symptoms of cat scratch disease are much more pronounced.

Diagnosis and treatment

We think of cat scratch disease when a person who has been scratched by a cat has had enlarged lymph nodes for more than three weeks. In unclear cases, a blood sample is taken to determine the presence of antibodies against the bacterium Bartonella henselae. Problems are mitigated by heating and taking painkillers. If the lymph node festers and is painful, we remove the pus with a needle, which relieves the pain. Antibiotics are prescribed for the final removal of bacteria, especially in patients with AIDS.

Infections with Pseudomonas bacteria

Infections with Pseudomonas bacteria are infectious diseases caused mainly by Pseudomonas aeruginosa bacteria. These bacteria cause two common but not serious diseases that can affect normally healthy people: inflammation of the external auditory canal, often in swimmers ("swimmer's ear"), and folliculitis after bathing in warm water.

Otitis externa is an infection of the external auditory canal caused by prolonged exposure to fresh water. It is treated with drops of antibiotics. Folliculitis after bathing in warm water is skin changes in the form of tiny bubbles, some of which may fester in the center. It is recommended to keep the skin dry and occasionally apply antibiotic ointment.

Image: More dangerous infections with Pseudomonas bacteria often occur in the hospital.

More dangerous infections with Pseudomonas bacteria most often occur in the hospital, where the microorganism is usually found in very humid areas, e.g., in spouts and urine collectors. Surprisingly, it is even found in some antiseptic solutions.

The most severe Pseudomonas infections occur in weakened people with a reduced immune response, either due to receiving drugs or other treatments or due to illness. Pseudomonas can infect the blood, skin, bones, ears, eyes, urinary tract, heart valves, and lungs. It also causes severe burn infections that can spread to the blood so that the patient dies.

Symptoms

Symptoms depend on the site of infection, but Pseudomonas infections tend to be severe. Malignant otitis media is an ear infection that can cause severe ear pain and nerve damage. It occurs very often in people with diabetes. After entering the eye, either through an injured site, an infected contact lens, or an infected lens fluid, Pseudomonas bacteria can cause ulcers in the eye. This type of infection can also be found in deep puncture wounds, especially on the legs of children.

Pseudomonas can cause severe pneumonia in hospitalized patients, especially in intensive care units. The bacterium often causes urinary tract infections, especially after urological procedures or in patients with urinary outflow disorders. The bacteria are often found in burn and cancer patients' blood. Without treatment, the infection cannot be controlled and can cause shock and death.

The infection often causes purplish-black skin lesions up to 1 cm in diameter, with an ulcer in the center and a reddened and swollen edge. Skin changes most often appear on the forearms and in the groin. Rarely, however, does Pseudomonas infect the heart valves. The risk is higher in people with artificial heart valves, but infection can also occur in natural heart valves, especially in intravenous drug users.

Treatment

If the infection is limited to external body parts, e.g., on the skin, dead tissue and larger pustules are surgically removed, and the affected area is washed with an antibiotic solution. Long-term intravenous antibiotic treatment is recommended for malignant inflammation of the external auditory canal, infection in the body, and blood infection. Infected heart valves can also be treated with antibiotics, but most often, open heart surgery is required to replace the valve.

Infections with Campylobacter bacteria

Campylobacter bacteria cause infections of the digestive tract and blood. The most common form of these infections is gastroenteritis, which can occur after drinking contaminated water, eating undercooked meat or poultry, or coming into contact with infected animals. Campylobacter bacteria can also cause diarrhea when traveling to less developed countries and blood infection (bacteremia), which occurs more often in people with previous illnesses, e.g., diabetes or cancer. The germ that causes stomach ulcers was once called Campylobacter pylori, but today, it is Helicobacter pylori.

Symptoms

Gastroenteritis caused by Campylobacter bacteria manifests in diarrhea, abdominal pain, and sometimes severe cramps. Diarrhea can be bloody, accompanied by a fever of 37.5 to 40 °C.

A body temperature that rises and falls may be the only symptom of Campylobacter infection outside the digestive tract. If the infection spreads throughout the body (systemic infection), painful, red, and swollen joints, abdominal pain, and an enlarged liver or spleen may occur. The infection rarely affects the heart valves (endocarditis) or the brain and spinal cord (meningitis).

Diagnosis and treatment

A laboratory test of a sample of blood, stool, or other body fluids can confirm that it is an infection with Campylobacter bacteria. It is treated with one or more antibiotics. Ciprofloxacin, tetracycline, and erythromycin are medications that usually clear the bacteria from the body and cure diarrhea. He is suffering from a blood infection, which is treated with antibiotics, which are injected into a vein.

Infections with enterobacteria

Enterobacteria are groups of bacteria that cause digestive tract infections or other organs. Many of these microorganisms usually inhabit the digestive tract. The group includes the bacteria Salmonella, Shigella, Escherichia, Klebsiella, Enterobacter, Serratia, Proteus, Morganella, Providencia, and Yersinia. Although it is normal for Escherichia coli (E. coli) to inhabit the digestive tract, certain strains can cause bloody, watery, or inflammatory diarrhea (traveler's diarrhea). In children, diarrhea caused by enterohemorrhagic strains of E. coli can cause hemolytic uremic syndrome, which destroys red blood cells and causes kidney failure.

Video content: Enterococcus - causes, symptoms, diagnosis, treatment, and pathology.

E. coli infection is often also the cause of urinary tract infections. However, it can also cause infections of the blood, gallbladder, lungs, and skin. In newborns, and especially premature babies, it can cause bacteremia and meningitis. We usually start treating patients with an antibiotic immediately, which is changed later if the culture result indicates a more effective antibiotic. An uncomplicated urinary tract infection can be treated with sulfonamides. The antibiotic must be given through intravenous injections in case of severe infections.

Infections with Klebsiella, Enterobacter, and Serratia bacteria usually occur in the hospital. It mainly affects people who have a reduced immune system against infections. The sites of infection are usually the same as for E. coli infection. Pneumonia caused by Klebsiella is rare but severe; it is most common in diabetics and alcoholics. Dark brown or dark red discharge is characteristic.

It can cause the formation of abscesses in the lungs and the collection of pus between the pleural membranes (empyema). If intravenous antibiotic treatment such as cephalosporins or quinolones is started early enough, pneumonia caused by Klebsiella bacteria is curable. A group of bacteria called Proteus is commonly found in soil, water, and feces. It causes infections inside the body, especially in the abdominal cavity, urinary tract, and bladder.

Typhoid

Typhoid is an infectious disease caused by the bacterium Salmonella typhi. Infected people excrete the bacteria in their feces and urine. If insufficient hand washing is done after defecation or urination, Salmonella typhi can be transferred to food and water.

Flies can directly transmit bacteria from feces to food. Infection rarely occurs in healthcare workers who have not taken adequate precautions when handling contaminated bedding. After entering the digestive tract, the bacteria enter the bloodstream. Inflammation of the small and large intestine occurs. In more serious, life-threatening cases, painful ulcers form on the affected area, which can burst.

Approximately 3 percent of untreated patients who become infected with Salmonella typhi bacteria excrete the bacteria in their feces for a year or more after infection. In some of these, typhoid symptoms never appear.

Salmonella and diagnosis

Symptoms usually appear slowly, eight to fourteen days after infection. The patient has a fever, headache, pain in the joints and throat, complains of constipation, loss of appetite, and pain in the abdomen, which is painful when pressed.

Pains when urinating, coughing, and nosebleeds occur less often. If the disease is not treated, in the next two to three days, the body temperature rises to 39.5 to 40 °C and persists for ten to fourteen days. At the end of the third week of the disease, it slowly decreases and reaches normal values in the fourth week. A slowed heart rate and marked exhaustion often accompany persistent fever.

In severe cases, delirium, complete numbness, and coma occur. In about 10 percent of patients, during the second week of the disease, small pink spots appear on the skin of the chest and abdomen in groups that are present for two to five days. Sometimes, the infection causes pneumonia-like symptoms, but it may only cause a fever or symptoms similar to a urinary tract infection. Although the symptoms and the course of the disease suggest typhoid fever, the diagnosis must be confirmed by identifying the bacteria in a blood, stool, urine, or other tissue culture.

Complications

Most patients recover completely. Complications occur, especially in untreated patients or patients treated too late. In most cases, bleeding from the intestines occurs in the third week of the disease; about 2 percent of patients bleed profusely. In 1 to 2 percent, the intestinal wall is perforated, and the contents of the intestine infect the abdominal cavity and cause severe abdominal pain (peritonitis).

In approximately 10 percent of untreated patients, the disease recurs two weeks after normalization of body temperature. However, for unknown reasons, this percentage is higher (15 to 20 percent) among those who received antibiotics during the initial period of the disease. In the case of a recurrence of the disease, the body temperature is normalized much faster with antibiotics than during the first appearance of the disease. Another recurrence of the disease usually follows.

Prevention and treatment

The oral typhoid vaccine protects only 70 percent. We vaccinate only those people who have been in contact with the infected and those exposed to the bacteria, i.e., laboratory workers who study the microorganism and people who travel to areas where the disease often occurs. People in such areas should not consume fresh leafy vegetables and other foods prepared or stored at room temperature.

Picture: the oral typhoid vaccine protects only 70 percent.

Freshly prepared, hot, or frozen foods, bottled carbonated drinks, and fresh foods that can be peeled are generally safe. We must boil or chlorinate water before drinking unless we know it is not contaminated. Typhoid fever is more than 99 percent curable if treated with antibiotics in time. Patients who die from typhoid tend to be either malnourished, very young, or very old. Numbness, coma, and shock indicate a more severe form of the disease and predict an unfavorable outcome.

The recovery period may take several months. With antibiotics, we can mitigate the course of the disease, limit complications, and shorten its duration. Cephalosporin III is the drug of choice in Slovenia. Generations and the alternative is quinolone or chloramphenicol. In delirium, coma, or shock, corticosteroids reduce brain inflammation.

What increases the risk of salmonella infection?

removal of part of the stomach
lack of stomach acid
infection with human immunodeficiency virus (also AIDS)
long-term use of antacids
sickle cell anemia
removal of the spleen
spotted typhus
malaria
bartonellosis
cirrhosis
leukemia
lymphoma

Due to bleeding from the gastrointestinal tract and other disorders in the digestive tract, the patient has to eat more often. Sometimes, intravenous feeding is necessary until the patient can digest food independently. Patients with a perforated intestinal wall need antibiotics that destroy as many bacteria as possible since various bacteria can float into the abdominal cavity. It is often necessary to restore or remove a perforated part of the intestinal wall with surgery.

The disease's recurrence is usually treated in the same way as the initial disease, and treatment with antibiotics lasts only five days. Bacillus carriers (people who excrete the bacteria in their feces but do not have disease symptoms) must be reported to the regional epidemiological service and prohibited from contact with food at work. In many bacillus carriers, the bacteria can be eliminated from the body after four to six weeks of antibiotic treatment.

Salmonella infections that do not cause typhoid

More than 2,200 salmonella serotypes, including the serotype that causes typhoid fever, are known. Each can cause indigestion, intestinal fever, and infections in limited body parts. The most common sources of Salmonella are contaminated meat, poultry, raw milk, eggs, and egg products. Still, they can also be infected by domesticated reptiles, carmine red dye, and anSalmonellaated marijuana.

Symptoms and diagnosis

Salmonella infections can cause indigestion or enteric fever, but sometimes, the infection is limited to only a specific body part. Some infected people have no symptoms but remain carriers of the bacteria. Indigestion usually occurs 12 to 48 hours after ingestion of Salmonella. The disease begins with nausea and crampy abdominal pain, soon followed by diarrhea, fever, and sometimes vomiting. The stools are softer and wateSalmonellay.

Problems are usually mild and last from one to four days but can last much longer. The diagnosis is confirmed in the laboratory by culture of a stool sample or rectal swab of an infected person. Enteric fever occurs when Salmonella enters the blood. An elevated body temperature causes extreme exhaustion. A typical example of this disease is typhoid fever. Other strains of Salmonella cause milder forms of the disease.

Salmonella can also cause an infection limited to a specific body part. They settle and reproduce SSalmonellain the gastrointestinal tract, blood vessels, heart valves, brain and spinal cord, lungs, joints, bones, urinary tract, muscles, or other organs. They also infect tumors and cause the formation of an abscess, from where the infection can spread to the blood. Bacillus carriers have no disease symptoms but excrete the bacteria in their feces. Less than 1 percent of people infected with non-typhoidal sSalmonellaexcrete the bacteria in their stools for a year or more after infection.

Treatment

Digestive disorders are treated by consuming liquid SSalmonellaand eating diet food. Antibiotics increase the time it takes for bacteria to be excreted in the feces and are, therefore, not recommended for patients who only complain of digestive problems. Antibiotics are used to treat children, people in care institutions, and people infected with the human immunodeficiency virus (HIV), as they are at a higher risk of developing complications. In asymptomatic bacillus carriers, the infection usually resolves on its own, so treatment with antibiotics is usually unnecessary.

When we decide on antibiotic treatment, we can choose between ampicillin, amoxicillin, or ciprofloxacin; their resistance is high. Such treatment should last from three to five days, and recurrence of the disease in HIV patients is usually prevented by more prolonged treatment. Salmonella blood infection is treated with antibiotics for four to six weeks. The abscesses are treated with surgical drainage of the pus and a four-week antibiotic treatment. Surgery and longer-term treatment with antibiotics are also usually necessary in case of infection of blood vessels, heart valves, or other limited inflammation.

Shigellosis

Shigellosis (bacillary dysentery) is an intestinal infection with Shigella bacteria that causes severe diarrhea. Shigella causes dysentery worldwide and accounts for 5 to 10 percent of diarrhea in many areas. The disease is spread by contact with the faeces of infected persons. Dysentery is also transmitted by oral-anal contact or by contact with contaminated food, water, objects, or flies. Epidemics most often occur in overpopulated areas with inadequate sanitation and hygiene. The disease usually develops more strongly in children.

Symptoms

Shigella invade through the mucous membrane of the intestinal wall and cause swelling and formation of shallow ulcers. Symptoms appear one to four days after infection. In young children, the disease begins suddenly, with fever, irritability, drowsiness, loss of appetite, nausea and vomiting, diarrhea, abdominal pain, flatulence, and pain during bowel movements. Within three days, pus, blood, and mucus appear in the stool. The number of bowel movements quickly increases to more than twenty per day. Considerable weight loss and severe dehydration occur.

In adults, the body temperature is not always elevated, and at the beginning of the disease, the stool is often not bloody or mucous. The disease begins with occasional abdominal pain, false straining to defecate, and passing solid stool, which temporarily relieves the pain. The problems appear more and more frequently and more prominently until the patient has severe diarrhea with mushy or liquid stools that contain mucus, pus, and often blood.

Patients often vomit and quickly become dehydrated. Severe dehydration, resulting in shock and death, occurs mainly in chronically ill adults and children under two years of age. Shigellosis is suspected in someone living where this type of infection is common. The culture of a fresh stool sample confirms the final diagnosis.

Complications

Shigellosis can cause delirium, convulsions, and coma, with little or no diarrhea. This form of the disease can cause death within 12 to 24 hours. Especially in weakened and dehydrated patients, shigellosis can be accompanied by other bacterial infections. Due to ulcers in the intestinal wall caused by shigellosis, the patient can lose a lot of blood.

Video content: Bacteria (updated).

Rare complications include nerve, joint, or heart damage and sometimes perforation of the intestinal wall. Severe straining during a bowel movement can cause rectal prolapse, in which part of the rectum is pushed out of the body. The result can be a permanent loss of bowel control.

Treatment

In most cases, the disease passes within four to eight days. In more severe cases, it can take three to six weeks. Shigellosis is treated by replacing the fluid and salt the body lost due to diarrhea. In very young patients, in a severe form of the disease,or when there is a risk of transmission of the infection to other people, we introduce antibiotic treatment. In Slovenia, the drug of choice is trimethoprimsulfamethoxazole, while the alternative is ampicillin, quinolone, or cephalosporin lil. Generations. Treatment can alleviate symptoms and shorten the time it takes for the shigella to be excreted in the feces.

Questions and answers

Is cholera deadly?

Cholera can quickly become fatal. In the most severe cases, rapid loss of large amounts of fluid and electrolytes can lead to death within hours. In less extreme situations, people who do not receive treatment can die from dehydration and shock hours to days after cholera symptoms first appear^[1].

How many bacilli do we know?

More than 20 species are recognized, but only Bacillus anthracis and B. cereus are causative agents in humans. The remaining Bacillus species can be isolated from the environment. They are found in water, plant material, soil, and dust, and they rarely cause disease in humans^[2].

What causes cholera infection?

Cholera is acute diarrhea caused by ingesting food or water contaminated with the bacterium Vibrio cholerae^[3].

How to avoid cat scratch infection?

Avoid scratching or biting cats or kittens. If you are scratched or bitten, wash the area immediately with soap and water. Do not allow cats to lick any wounds you may have^[4].

Is cholera treated with antibiotics?

Severe cases require prompt treatment with intravenous fluids and antibiotics. Ensuring safe water and basic sanitation and hygiene practices are critical to preventing and controlling cholera transmission and other water-borne diseases^[3].

Who most often gets typhoid fever?

Typhoid mainly affects the countries of South and Southeast Asia, Central and South America, Africa, and the Caribbean. Travelers are most at risk when visiting Pakistan, India or Bangladesh. Children get typhus more often than adults^[5].