Disease >> Internal Medicine >> Gastroenterology

Viral enteritis

Introduction
Cause
Prevention
Complication
Symptom
Examine
Diagnosis

Introduction

Introduction to viral enteritis Viral gutitis (viral gastroenteritis), also known as viral diarrhea, is a group of acute intestinal infections caused by a variety of viruses. The clinical features are acute onset, nausea, vomiting, abdominal pain, diarrhea, drainage or loose stools, fever and general malaise, short duration and low mortality. The clinical manifestations of gastroenteritis caused by various viruses are basically similar. There are many types of viruses associated with acute gastroenteritis, among which the more important ones are rotavirus and norovirus. In addition, cup-like virus, intestinal adenovirus, astrovirus, coxsackie virus, coronavirus, etc. can also cause gastroenteritis. There is no specific treatment for this disease, mainly symptomatic treatment. Suspend milk and disaccharide foods. Use antiemetics and sedatives when vomiting and diarrhea are heavy. Oral or intravenous rehydration to correct and electrolyte imbalance. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: blood in the stool, iron deficiency anemia

Cause

Cause of viral enteritis

Environmental factors (30%)

The route of transmission is mainly transmitted through humans, through fecal-oral or oral-oral transmission, and may also be transmitted through water pollution or respiratory tract. Adult rotavirus gastroenteritis (epidemic diarrhea) is often a water-type outbreak and can also be transmitted through life contacts.

Virus infection (35%)

The common rotavirus in susceptible population mainly invades infants and young children, with the highest incidence rate from 9 to 12 months old, and rare under 6 months old. However, recent artificial feeding of newborns is also more common, and adults are more asymptomatic or mildly manifested after infection. . Adult diarrhea rotavirus is generally prevalent, but it is mainly prevalent in young adults.

Climate factors (30%)

The incidence has obvious seasonality, and the peak incidence is in the cold season of autumn and winter (December to February), but the seasonality in the tropics is not obvious. Rotavirus adult diarrhea can occur throughout the year, but epidemics and outbreaks occur in China from April to July.

Pathogenesis

The virus mainly invades the intestinal epithelial cells of the small intestine, causing the epithelial cells to fall off and replacing them with squamous or square epithelial cells lacking digestive enzymes. Therefore, the presence of villous enzymes such as maltase, sucrase, and lactase on the normal intestinal mucosa is reduced, resulting in absorption dysfunction. Since lactose and other disaccharides cannot be digested and absorbed, they remain in the intestine, causing changes in the osmotic pressure of the intestinal mucosa and the intestinal lumen, causing the liquid to enter the intestinal lumen and causing osmotic diarrhea.

The lesions are mainly located in the duodenum and jejunum. Epithelial cells can be square or not shaped, but most intestinal mucosal cells are still normal. There is vacuolar degeneration in the intestinal villus epithelial cells, and there are a large number of rotavirus particles in the endoplasmic reticulum.

Prevention

Viral enteritis prevention

Early detection and isolation of patients, disinfection of patients' feces, attention to water and food hygiene, disinfection of tableware, baby rooms should have a strict disinfection and isolation system.

Complication

Viral enteritis complications Complications, blood in the stool, iron deficiency anemia

First, chronic enteritis is prone to cause serious complications. Toxic intestinal dilatation is a serious complication of chronic enteritis. It occurs in patients with total colitis. The mortality rate can be as high as 44%, and it is easy to be complicated with intestinal perforation. Severe perforation.

Second, chronic enteritis induced by blood in the stool, blood in the stool is one of the main clinical manifestations of enteritis, the number of blood in the stool is also an indicator of the severity of the disease. In addition, long-term chronic bleeding is likely to cause iron deficiency anemia, then you must pay attention to timely blood transfusion therapy.

Third, chronic enteritis diarrhea hidden polyps, many patients with cancer thought that diarrhea is only caused by general cold, unhealthy diet and other reasons, in fact, chronic enteritis is the most common cause. And in fact, patients with chronic enteritis for more than five years, causing intestinal polyps, and intestinal polyps cancer rate is extremely high.

4. Chronic enteritis is too long to prevent intestinal stenosis. Intestinal stenosis occurs in cases of enteritis with extensive lesions and duration of 5 to 25 years. In severe cases, it can cause intestinal obstruction. In case of intestinal stenosis, be alert to tumors. To identify benign and malignant.

Symptom

Viral enteritis symptoms common symptoms watery stool chronic abdominal pain nausea and vomiting fever abdominal pain diarrhea

Infant rotavirus has the highest incidence rate from 9 to 12 months old, and is rare under 6 months old. However, the number of artificially fed neonates has been more frequent recently, and adults are more asymptomatic or mildly manifested after infection. Adult diarrhea rotavirus is generally prevalent, but it is mainly prevalent in young adults. Patients with infections and asymptomatic carriers are the main source of infection. The route of transmission is mainly transmitted through humans, through fecal-oral or oral-oral transmission, and may also be transmitted through water pollution or respiratory tract.

Ordinary rotavirus enteritis, incubation period of 1 to 3 days. The condition varies greatly. The symptoms of children aged 6-24 months are heavy, while the older children or adults are mostly mild or subclinical. Acute onset, more vomiting and diarrhea, with mild, moderate fever.

Adult diarrhea rotavirus enteritis incubation period of 2 to 3 days, acute onset, no fever or only low fever, with diarrhea, abdominal pain, abdominal distension as the main symptoms. Diarrhea varies from 3 to 10 times a day. It is yellow water or rice soup, and there is no pus. Some patients have symptoms such as nausea and vomiting. The course of disease is 3 to 6 days, and occasionally it can last for more than 10 days.

Examine

Examination of viral enteritis

1. The total number and classification of peripheral blood leukocytes in blood routine are mostly normal, a few are high, and the classification of lymphocytes increases;

2. Most of the stool routine and culture stool microscopy have no special findings, a small number of white blood cells can be seen, and no growth of pathogenic bacteria can be cultivated;

3. Specific diagnostic test (1) taking feces for direct or immunoelectron microscopy, rotavirus particles can be found; (2) detecting virus in fecal supernatant by enzyme-linked immunosorbent assay or immunoenzymatic spot test (Immnnoenzymedottest) Antigen, with high sensitivity and specificity; (3) Extracting viral RNA from feces, performing polyacrylamide gel electrophoresis and silver staining, and examining the presence or absence of rotavirus RNA electropherogram, which has both diagnostic value and Different types of virus infection can be distinguished; (4) Serological test, 5 days after infection, specific IgM antibodies can be detected in the blood, which is also helpful for the diagnosis of this disease.

Diagnosis

Diagnosis and identification of viral enteritis

(1) The watery diarrhea that occurs in epidemiology in autumn and winter, especially in the case of more cases, should consider the possibility of this disease;

(2) Clinical manifestations of acute watery diarrhea, the symptoms of poisoning are mild, and the course of disease is self-limiting;

(3) Laboratory inspection