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home - Colon - Colonic Infection - Rotavirus 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.

Rotavirus

Incubation period of -Virus can be found up to 30 days later-Asymptomatic excretion of rotaviruses in stool occurs may play a role in transmission. Associated illnesses and complications:Necrotizing enterocolitis- in neonates.Intussusception- probably localised oedema of bowel wall.Biliary atresia- possibly a case report association.CNS complications- esp. seizures and encepha-lopathy.Persisting GI symptoms- carbohydrate intoler-ance or lactase intolerance may persist after the resolution of diarrhoea. Diagnostic Techniques:-ELISA, and latex agglutination to detect rotavirus group antigen present on VP6.Cell culture- can be laborious. Rotavirus Clinical PresentationIt is the most common cause of paediatric gastroenteritis.It peaks in the winter.There is a west to east spread across US and Europe.The pattern of virus shedding in symptomatic cases closely parallels the temporal development of illness. 3 Effects:-Loss of brush border enzymes-The direct effect GI toxicof the rotavirus enterotoxin NSP4-Activation of the enteric nervous system by infection with subse-quent fluid and electrolyte secretion. -Patchy irregularities of duodenum and jejunumShortened and blunted villi-Increased infiltration of the lamina propria with monon-clear cells.-Rotavirus particles in the epithelial cells.-Patches resolve. Pathogenesis Disease in adults: Mild and seen in families of affected childrenSimilar presentation to children.Immunodeficiency — Especially if have T-cell immunodeficiencies or SCIDS, and after bone marrow transplantationNot common in HIV Written by Dr Sebastian Zeki

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