Gene/Protein Disease Symptom Drug Enzyme Compound
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 15,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventeen years after its recognition, outbreaks and sporadic infections attributed to Escherichia coli O157 continue to increase. Acute gastrointestinal, and the systemic complications haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP), are frequent and severe. Current challenges that face clinicians are the early recognition of infection, identification of risk factors for poor prognosis, determination of appropriate monitoring for the development of complications, establishment of a therapeutic strategy and, finally, advice for patients about their long-term prognosis. Clinical features which, in combination, have been shown to distinguish E. coli O157 infection from other enteric pathogens are a history of bloody diarrhoea, visibly bloody stools, absence of fever, a leucocyte count greater than 10 x 10(9) l(-1) and abdominal tenderness on physical examination. The most consistent risk factors for the development of HUS/TTP are the extremes of age and a raised leucocyte count. Bloody diarrhoea and 'antimotility' drugs are also likely to be important risk factors. Recent evidence from the central Scotland outbreak suggests that individuals who are taking drugs that reduce gastric acidity or antibiotics at the time of infection with E. coli O157, or who have a short incubation period, may also be at increased risk of progression to HUS/TTP. Clinical management, in particular the role of antibiotics in gastrointestinal infection, remains controversial, and retrospective assessment of the 1996 outbreaks from central Scotland and Japan only adds to this controversy. Therapeutic plasma exchange is a promising treatment for adults who develop HUS/TTP, but its role has yet to be determined definitively, either in a randomized controlled trial or by an international register of cases. Significant chronic sequelae of infection occur, particularly irritable bowel syndrome after uncomplicated gastrointestinal infection, and renal failure after HUS/TTP. Their frequency and severity are likely to become evident over the next decade.
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PMID:Clinical presentation, complications and treatment of infection with verocytotoxin-producing Escherichia coli. Challenges for the clinician. 1088 Jan 76

Gastrointestinal infections are the significant cause of childhood morbidity and mortality worldwide. Gastrointestinal infections reflects the balance between the intrinsic virulence factors of the enteropathogens and host mechanisms which defend against enteric infections. Host defense factors include gastric acidity, intestinal motility, the normal indigenous intestinal microflora, mucous secretion, and specific mucosal and systemic immune mechanisms. Majority of GI infections are self limited so on one hand antibiotics are not needed and on the other hand the irrational use of antibiotics produces resistant strains. Acute diarrheal diseases which are one of the important intestinal infections, in majority of the cases are viral and have short course. Antibiotics are recommended only in specific cases and in immunocompromised individuals. Gastrointestinal disease is one of the most common manifestations of HIV infection. The gastrointestinal tract contains abundant quantities of lymphoid tissue and is likely to function as a reservoir of HIV infection, a site of profound immune dysregulation, and a target for opportunistic infections. In this situation specific antibiotics are indicated.
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PMID:Intestinal infections. 1198 Apr 61