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home - Colon - Colonic Infection - Astrovirus Written by Dr Sebastian Zeki
Knowledge

Recognises the range of important inflammatory conditions of the
intestine other than inflammatory bowel disease
Knows the range of potential aetiologies including infection and
ischaemia
Understands how diverticular disease can give rise to complications mini-CEX, SCE 1
Knows how diseases can affect the peritoneum and how such
conditions can present both in the acute and chronic situation
Knows the range of both acute and chronic intestinal infections and
their various presentations
Knows the means of investigations of infectious diseases and
understands the principles and use of antimicrobial therapy

Skills
Makes a full clinical assessment of patients presenting with infective
and inflammatory conditions
Recognises the potential urgency of the clinical situation. Selects
appropriate investigations and treatments

Behaviours
Manages patients with inflammatory and infective conditions carefully,
competently and sympathetically.

Astrovirus

Measures to prevent Viral Gastroenteritis:Standard enteric precaution.Handwashing -reduces diarrhoeal risk by 47 %.Barriers eg wearing gloves.Cohorting if slow to control outbreaks.If in paediatric hospitals need nappy handling.Chase source of outbreak.in the case of norovirus on cruise ships: Isolate ill crew and passengers and disinfect ships with chlorine solutions, phenol-based compounds, or accelerated hydrogen peroxide products Small intestinal villus shorten-ing and with mild inflamm-tory infiltrates in the lamina propria 8 serotypes HastV-1 to HAstV-8 Usually in childrenLow-grade fever but also in immunocompromised and elderlyDiarrheaHeadacheMalaiseNauseaVomiting is less common Incubation preiod: 3-4 daysCauses 5% diarrhoea in daycare centres Symptoms for 2-3 days Astrovirus Vaccine development Rotavirus — Vaccine has developed.Norovirus — Immunity is of short duration, and reinfections are common. Fluid replacement is most important. No specific antiviral agents are available.Oral rehydration —ie WHO solution.Medications for symptomatic treatment — -Oral bismuth subsalicylate: reduces severity and duration of abdominal cramping, but not number, weight and water content of stools or the amount of virus excreted.The efficacy and safety of loperamide is uncertain.Immune globulin containing antibodies to rotavirus:Some succes in immunodeficient children with chronic rotavirus illness. -Not that effective in normal children.-Egg yolk immunoglobulin, derived from chicken hyperimmu-nized with human rotavirus, has been used to treat rotavirus-infected children with modest improvement in the severity of diarrhea. Treatment Written by Dr Sebastian Zeki

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