Different E. coli - different diseases
Pathogenic Escherichia are divided into groups according to their mechanism of action. Some attach to the intestinal wall and release toxins, causing large, watery stools without blood—they are most often responsible for traveler's diarrhea. Others penetrate the mucous membrane and give a picture similar to dysentery, mixed with mucus and blood. A special group consists of strains that produce a powerful toxin: they cause bloody diarrhea and can damage the small vessels of the kidneys. It is not easy to separate these options by symptoms, so in severe cases a culture is needed.
- Watery diarrhea without blood in most patients
- Dysentery-like form with mucus and blood
- Toxin-producing strains with bloody stools
- Travelers' diarrhea when changing regions
- A separate form is E. coli as a cause of urinary tract infection
How do they get infected?
Infection always occurs through the mouth. Sources include contaminated water, food that has not undergone sufficient heat treatment, as well as hands and kitchen surfaces. Dangerous are undercooked minced meat, unpasteurized milk and cottage cheese made from it, unwashed greens and vegetables, salads prepared in advance and kept warm. Transmission from person to person in families and children's groups is possible, especially if hygiene after using the toilet is not maintained. During the hot season, the risk increases: bacteria multiply quickly in prepared food left at room temperature.
- Unboiled and contaminated water
- Undercooked meat and minced meat
- Unpasteurized milk and milk products
- Poorly washed vegetables, herbs, fruits
- Prepared food kept warm
- Contact with the sick and dirty hands
Symptoms
Typically, a few hours or days after infection, abdominal cramps, rumbling, and then loose stools appear, and in some people, nausea and vomiting. The temperature may be normal or moderately elevated. In the watery form, the danger is created by loss of fluid and salts, especially in young children and the elderly. When the colon is affected, the stool is scanty, with mucus and blood, the pain is cramping and severe. The combination of bloody diarrhea with a decrease in the amount of urine and pallor is considered alarming - this can lead to kidney damage.
- Loose stools, watery to scanty with mucus
- Cramping pain in the abdomen
- Nausea and vomiting
- Weakness, dry mouth, thirst
- An increase in temperature is not always
- Blood in stool with certain strains
Survey
For mild cases without blood in the stool, tests are often not needed: the diagnosis is made in the clinic, and treatment is the same for most viral and bacterial diarrhea. Examination is necessary in severe cases, blood in the stool, prolonged fever, in young children, the elderly and people with reduced immunity. Stool culture of the intestinal group reveals the pathogen and its sensitivity to antibiotics. A complete blood count, electrolytes, creatinine, and urea help assess dehydration and kidney function. If kidney damage is suspected, monitoring of urine and platelet analysis is mandatory.
- Culture of stool for intestinal group
- Coprogram for assessing inflammation in the intestines
- General blood test
- Electrolytes, creatinine, urea
- Urinalysis for bloody diarrhea
- Assessing the degree of dehydration upon examination
Treatment and prevention
The basis of treatment is to replenish fluid and salt losses. Ready-made solutions for oral rehydration are suitable, which are drunk often and in small portions, especially for children after each episode of bowel movement. In the diet, the usual food is left in a gentle form: porridge, boiled vegetables, crackers, soups; breastfeeding is not interrupted. Sorbents may reduce symptoms. Drugs that stop peristalsis are contraindicated for bloody diarrhea and high fever. Not everyone needs antibiotics: if strains that produce a toxin are suspected, they can even worsen the course, so only a doctor prescribes them. For severe dehydration, fluids are given intravenously in the hospital.
- Oral rehydration in small, frequent doses
- Gentle nutrition, continued breastfeeding
- Sorbents as prescribed by a doctor
- Avoidance of drugs that stop peristalsis for bloody diarrhea
- Antibiotics strictly as prescribed
- Intravenous solutions for severe dehydration
- Prevention: boiled water, washing hands and food, frying meat