Abetalipoproteinemia ischaracterizedbyaninabilitytosecretetriglyceride-richlipoproteinsduetoaninheritedtransepithelialtransportdefect.
Thetwoformsofmicroscopiccolitis,collagenous colitis andlymphocytic colitis, bothcausechronicwaterydiarrhea.Theintestinesaregrosslynormal,andthediseasesareidentifiedbytheirhistologicfeatures.
This global problem is responsible for more than 1 million deaths annually and greater than 10% of all deaths in patients younger than 5 years of age worldwide. Enterocolitis presents with a broad range of signs and symptoms, including diarrhea, abdominal pain, urgency, perianal discomfort, incontinence, and hemorrhage. Bacterial infections, such as enterotoxigenic Escherichia coli, are frequently responsible, but the most common pathogens vary with age, nutrition, and host immune status, as well as environment (
Table 15.4 ). For example, epidemics of cholera are common in areas with poor sanitation, as a result of inadequate public health measures, or as a consequence of natural disaster (e.g., the Haitian earthquake of 2010) or war. Pediatric infectious diarrhea, which may result in severe dehydration and metabolic acidosis, is commonly caused by enteric viruses. A summary of the epidemiology and clinical features of selected causes of bacterial enterocolitis is presented in
Table 15.4.
Representative bacterial, viral, and parasitic enterocolitides are discussed next.
Vibrio cholerae organisms are comma-shaped, gram-negative bacteria that cause cholera, a disease that has http://ebooksmedicine.net
Table 15.4 Features of Bacterial Enterocolitides
CholeraIndia,AfricaShellfishFecal-oral,waterSporadic,endemic,SmallintestineSeverewateryDehydration,electrolyteepidemic
Campylobacter spp.DevelopedcountriesChickens,sheep,pigs,Poultry,milk,Sporadic;children,ColonWateryorbloodyArthritis,Guillain-Barrécattleotherfoodstravelers
ShigellosisWorldwide,endemicHumansFecal-oral,food,Children,migrantLeftcolon,BloodydiarrheaReactivearthritis,urethritis,indeveloping waterworkers,travelers,ileum conjunctivitis,hemolytic-countries http://ebooksmedicine.net
SalmonellosisWorldwidePoultry,farmanimals,Meat,poultry,eggs,Children,olderadultsColon,smallWateryorbloodySepsis,abscessreptilesmilk
Enteric(typhoid)feverIndia,Mexico,HumansFecal-oral,waterChildren.adolescents,SmallintestineBloodydiarrhea,Chronicinfection,carrierstate,Philippines feverencephalopathy,myocarditis,intestinalperforation
Yersinia spp.NorthernandPigs,cows,puppies,catsPork,milk,waterClusteredcasesIleum,Abdominalpain,fever,Reactivearthritis,erythemacentralEurope appendix,diarrheanodosumrightcolon