Ch. 19 - Digestive System Infections

Norman-McKay- Microbiology: Basic and Clinical Principles 2nd Edition

Norman-McKay2nd EditionMicrobiology: Basic and Clinical PrinciplesISBN: 9780137661619Not the one you use?Change textbook

Norman-McKay 2nd Edition

Ch. 19 - Digestive System Infections

Problem 21

Chapter 19, Problem 21

Which of the following is most controversial for a nonseptic patient with E. coli O157:H7?
a. Administering oral rehydration therapy
b. Administering antibiotic therapy
c. Administering fever-reducing medications
d. Administering intravenous rehydration therapy
e. Withholding agents like diphenoxylate-atropine that reduce GI tract motility

Verified step by step guidance

Step 1: Understand the clinical context of E. coli O157:H7 infection, which is a strain known to cause severe gastrointestinal illness, including hemorrhagic colitis and hemolytic uremic syndrome (HUS).

Step 2: Recognize that in nonseptic patients (those without systemic infection), treatment focuses on supportive care rather than aggressive interventions.

Step 3: Review the role of antibiotics in E. coli O157:H7 infections. Antibiotic therapy is controversial because it may increase the risk of HUS by causing bacterial lysis and release of toxins.

Step 4: Consider the safety and appropriateness of other options: oral and intravenous rehydration are standard supportive treatments; fever reducers are generally safe; and agents that reduce GI motility are usually withheld to avoid prolonging toxin exposure.

Step 5: Conclude that among the options, administering antibiotic therapy is the most controversial choice for a nonseptic patient with E. coli O157:H7 due to potential risks outweighing benefits.

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Key Concepts

Here are the essential concepts you must grasp in order to answer the question correctly.

E. coli O157:H7 Pathogenesis and Clinical Presentation

E. coli O157:H7 is a shiga-toxin producing strain causing severe gastrointestinal illness, often with bloody diarrhea. It can lead to complications like hemolytic uremic syndrome (HUS), especially in children. Understanding its pathogenesis helps explain why certain treatments may be risky or beneficial.

Controversy of Antibiotic Use in E. coli O157:H7 Infections

Antibiotic therapy in E. coli O157:H7 infections is controversial because some studies suggest antibiotics may increase toxin release, raising the risk of HUS. Therefore, antibiotics are generally avoided unless absolutely necessary, highlighting the importance of cautious treatment decisions.

Supportive Care and Management of E. coli O157:H7

Supportive care, including oral or intravenous rehydration, is the mainstay treatment for E. coli O157:H7 infections. Fever reducers and agents that slow GI motility are used cautiously or avoided to prevent worsening symptoms or complications, emphasizing the focus on symptom management rather than aggressive interventions.

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True or False: Giardia infections in the United States are all imported from other countries.

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Larry goes to his local Red Cross center to donate blood for the first time. A few weeks later a Red Cross agent contacts him to ask him to come in for a confidential meeting. During the meeting, Larry learns that his blood tested positive for hepatitis. He claims to be in excellent health and doesn’t believe the diagnosis. What virus does Larry most likely have? (NCLEX/HESI/TEAS)

a. Hepatitis A

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c. Hepatitis C

d. Hepatitis D

e. Hepatitis E

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Textbook Question

A lower endoscopy examination of a patient complaining of abdominal cramps and diarrhea reveals pus-laden patches along the intestinal wall. Which of the following infectious agents could be considered the pathogen responsible for this condition?

a. Clostridioides difficile

b. Shigella

c. Salmonella serotype Typhi

d. Helicobacter pylori

e. Campylobacter jejuni

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