1/22. Eosinophilic gastroenteritis involving the distal small intestine and proximal colon.Eosinophilic gastroenteritis (EG) is an unusual disorder. It is characterized by eosinophil infiltration of the gut wall histologically and is manifested by gastrointestinal (GI) symptoms clinically. This disease entity preferentially affects the stomach and proximal small intestine. Mucosal layer disease is the most common form of this uncommon disease. We present a case of EG with transmural distal small intestinal and proximal colonic involvement whose clinical symptoms included watery diarrhea, abdominal pain, and body weight loss. colonoscopy showed non-specific colitis in the proximal colon. Small bowel series showed diffuse jejunal dilatation with wall thickening and rigidity. Abdominal computed tomography also showed a thickened bowel wall with partial ileus and ascites. Diagnosis was established through endoscopic biopsy and ascites paracentesis, while at the same time excluding the possibility of parasite infection. Treatment with prednisolone produced a dramatic response. A high index of suspicion in cases of peripheral eosinophilia with concomitant GI symptoms is needed for the early diagnosis of this uncommon disease.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
2/22. Transmission of campylobacter hyointestinalis from a pig to a human.We report on a case of human gastroenteritis caused by the pathogen campylobacter hyointestinalis. Recurrent watery diarrhea and intermittent vomiting were the most significant symptoms of the previously healthy patient. Whole-cell protein electrophoresis and 16S rRNA gene sequencing were used to identify this Campylobacter species. Investigation of the patient's surroundings led to the recovery of a second C. hyointestinalis strain originating from porcine feces. Subsequent typing of the human and the porcine isolates by pulsed-field gel electrophoresis revealed similar macrorestriction profiles, indicating transmission of this pathogen.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
3/22. Successful treatment of Good syndrome with cytomegalovirus duodenoenteritis using a combination of ganciclovir and immunoglobulin with high anti-cytomegalovirus antibody titer.We describe the case of a 64-year-old woman with Good syndrome who presented with watery diarrhea and abdominal distention caused by cytomegalovirus (CMV) duodenoenteritis. thymoma and hypogammaglobulinemia were first identified when the patient was 58 years old. She had repeatedly complained of symptoms even after thymectomy. Abdominal radiography revealed multiple air-fluid levels, and computed tomography revealed ascites and dilation of the small intestine. Immunofluorescent staining of specimens obtained by duodenal mucosal biopsy revealed intracellular inclusion bodies of CMV, although serum CMV pp65 antigenemia assays yielded negative results. CMV infection of the small intestine caused mucosal edema resulting in malabsorption. The patient was treated using ganciclovir and an immunoglobulin preparation with a high titer of antibodies against CMV (CMV-Ig), and subsequently made a rapid recovery from abdominal symptoms. When patients with Good syndrome complain of abdominal symptoms, particularly chronic diarrhea, a diagnosis of CMV gastroenteritis should not be excluded, even if negative results are obtained for CMV pp65 antigenemia assays. Combination therapy of ganciclovir and CMV-Ig seems useful for patients with CMV gastroenteritis.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
4/22. Spontaneous oesophageal perforation as a complication of vomiting in gastroenteritis -- case report.This is a case report of oesophageal perforation as the complication of a commonly encountered benign disease -- gastroenteritis. A 68-year-old man first presented to the Emergency Department complaining of watery diarrhoea. He was treated and discharged. He re-attended 5 h later complaining of epigastric pain radiating to his back, vomiting bloodstained fluid and persistent watery diarrhoea. Again, he was treated and discharged. He re-attended 3 days later complaining of anorexia, cough, dyspnoea and right-sided chest pain radiating to his back, and subjective weight loss in the previous few days. Chest X-ray revealed right pleural effusion, pneumomediastinum and subcutaneous emphysema in the supraclavicular fossae. Computed chest tomogram and water-soluble contrast swallow confirmed 'spontaneous' oesophageal perforation. Although rare, this entity must be considered in any acutely ill patient complaining of respiratory and gastrointestinal symptoms, especially after recent vomiting.- - - - - - - - - - ranking = 3keywords = water (Clic here for more details about this article) |
5/22. Viral gastroenteritis: the USS THEODORE ROOSEVELT experience.Although the spread of disease on board Navy ships is not a novel concept, the medical department of the USS THEODORE ROOSEVELT recently experienced a significant outbreak of viral gastroenteritis while at sea. The impact on the crew and medical department is reviewed in this case report. The use of the Navy disease Non-Battle Injury tracking system was validated. Furthermore, we proposed the placement of waterless, isopropyl alcohol-based, hand-cleaning systems in strategic locations throughout the ship, to help prevent and minimize the spread of future disease. Finally, more stringent recommendations regarding sick in quarters status and careful utilization of consumable resources are necessary components of an effective outbreak management strategy.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
6/22. Human salmonellosis transmitted by a domestic turtle.salmonella typhimurium was isolated in the culture test of a small child admitted to hospital suffering from febrile gastroenteritis with stools containing traces of mucus and blood. Her mother also resulted positive for this microorganism. The family had recently bought a small turtle, imported from florida, at the city fair. Further tests revealed salmonella typhimurium in both the turtle's feces and the water in its tank.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
7/22. glucose polymers in diarrhoea--risk of hypernatraemia.An infant girl with congenital heart disease was fed glucose polymers as dietary supplements. During an attack of gastroenteritis with severe diarrhoea she developed hypernatraemic dehydration, probably due to the high osmotic load of the glucose polymers. This case illustrates the importance of giving adequate amounts of free water to a child on glucose polymers, especially during excessive fluid loss.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
8/22. Isolation of vibriostatic agent O/129-resistant vibrio cholerae non-o1 from a patient with gastroenteritis.A strain of vibrio cholerae non-o1 was isolated from a 48-year-old male in california who presented with a chief complaint of watery diarrhea. Laboratory investigations of this strain revealed the bacterium to be resistant to trimethoprim-sulfamethoxazole and to the vibriostatic agent O/129 (2,4-diamino-6,7-diisopropylpteridine).- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
9/22. Eosinophilic gastroenteritis with severe protein-losing enteropathy: successful treatment with budesonide.We report the clinical, laboratory, endoscopic and histopathological findings in a 40-year-old woman with watery diarrhoea and hypoproteinaemia. Elevated alpha(1)-antitrypsin clearance confirmed massive protein-losing enteropathy. Gastroscopic and colonoscopic biopsies showed abundant infiltration of the small bowel wall with eosinophils in proximal duodenum and terminal ileum, respectively. These findings established the diagnosis of eosinophilic gastroenteritis. Both the inflammatory alterations and the severe intestinal protein loss were successfully treated with budesonide, a topically active corticosteroid preparation with controlled small bowel release. The case report illustrates that remission of protein-losing enteropathy secondary to eosinophilic gastroenteritis can be achieved with budesonide, thus supporting its use for this uncommon disease characterised by inflammatory intestinal lesions.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
10/22. isospora belli infection. A report of two cases in patients with AIDS.OBJECTIVE: To present the findings of isospora belli infection in two patients with the acquired immunodeficiency syndrome (AIDS). CLINICAL FEATURES: One patient was part Aboriginal, the other an immigrant recently arrived from peru. Both men were infected with the human immunodeficiency virus (hiv). They presented with watery diarrhoea, one with severe weight loss. isospora belli oocysts were detected in multiple faecal specimens from both patients. One patient had a concomitant infection with cryptosporidium sp. INTERVENTION AND OUTCOME: There was a rapid response to treatment with cotrimoxazole (960 mg, four times a day for 10 days). A complete response was obtained in the patient with concurrent cryptosporidiosis. The diarrhoea recurred after cessation of treatment, necessitating maintenance therapy. CONCLUSION: Although isospora belli is an uncommon cause of gastroenteritis in australia, it is increasingly recognised as a cause of diarrhoea in travellers, immigrants from endemic areas and immunocompromised people. It has also been reported in the Aboriginal community; this article reports the first case of AIDS-related isosporiasis in an Aborigine. It is likely that both patients acquired isospora belli before they become hiv seropositive.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
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