Diarrhea is watery with mucus odor without pus and blood

Introduction Gastroenteritis caused by intestinal bacteria such as Escherichia coli can cause diarrhea as a symptom of watery mucus and no pus and blood, and the symptoms are light and heavy, and the treatment methods are also light and urgent. Enterobacteriaceae includes a large group of Gram-negative bacilli with similar biological traits. Most of these bacteria are found in the intestines of humans and animals. They can be widely distributed in water, soil and rot with human and animal excretions. Some of them have obvious pathogenic effects on humans, such as Salmonella and Shiga. Genus and certain pathogenic Escherichia coli and the like.

Cause

Enterobacteriaceae includes a large group of Gram-negative bacilli with similar biological traits. Most of these bacteria are found in the intestines of humans and animals. They can be widely distributed in water, soil and rot with human and animal excretions. Some of them have obvious pathogenic effects on humans, such as Salmonella and Shiga. Genus and certain pathogenic Escherichia coli and the like. Most of them are normal intestinal flora, which is generally not pathogenic, but when the host's body changes or the bacteria enters the intestine, it can also cause various diseases such as bacteremia meningitis. , pneumonia, pyelonephritis or wound infections and other diseases.

an examination

Related inspection

Fecal bacterial flora

Clinical manifestations: Due to the virulence, invasion and body resistance of the five different types of Escherichia coli, the clinical manifestations were also unhealthy.

One type is that bacteria only attach to the intestinal mucosa to grow and produce enterotoxin. By activating the adenylyl cyclase of intestinal wall cells, when the level of intracellular cyclic adenosine monophosphate (cAMP) is elevated, it can promote intestinal secretion. (LT), and intestinal hypersecretion caused by ST toxin is cyclized guanosine (cGMP) mediated. At the same time, enterotoxin can also damage the epithelium of the surrounding blood vessels, causing a healthy search for diarrhea, and discharging a large amount of watery stools (clinically similar to cholera-like diseases). Another type is that bacteria can invade intestinal mucosal epithelial cells to multiply and produce toxic substances, causing a network of liquid to overflow into the intestinal lumen, and finally epithelial cells rupture, leading to intestinal mucosal necrosis and ulceration, and stool with pus and blood (clinical Similar to dysentery-like illness). The main lesions are mainly ileum.

Incubation period

In a short period of only a few hours, Escherichia coli food poisoning can cause vomiting and diarrhea within 2 hours. The general incubation period is 1 to 3 days.

2. Clinical manifestations

(1) Light type: generally does not produce fever, with loss of appetite and diarrhea as the main performance. Every day, stools vary from 3 to 6 times. They are often yellow or green indigestion-like loose stools. Most of them are thin soups mixed with a small amount of foam, accompanied by abdominal distension, abdominal pain and nausea.

(2) Medium: There may be a low-heat health search. In addition to mild symptoms, there are frequent nausea, vomiting, diarrhea, frequent watery stools, mild dehydration and acidosis.

(3) Heavy: The body temperature is irregularly hot, 38 to 40 °C for several days, diarrhea 10 to 20 times a day, often yellow-green watery stool, mixed with a small amount of mucus, may have a scent or milk color or Rice soup-like, similar to cholera, mostly nausea and vomiting, infants often have convulsions. Acute renal failure can occur due to a large number of vomiting and diarrhea symptoms of dehydration and acidosis. About 30% of ETEG diarrhea children in Bangladesh have moderate or severe dehydration. In adult cases, there are more severe dehydration, and often cannot be distinguished from cholera. If the treatment is not timely, infants and young children can die within a few days. EIEC diarrhea is similar to acute dysentery. The main symptoms of EHEC infection are bloody stools and severe abdominal pain. The diarrhea caused by EAEC is persistent (>14 days), with bloody stools and fever (38 °C) and vomiting.

Differential diagnosis

Differential diagnosis:

The causes of diarrhea are complex, such as bacteria, viruses, parasites, etc. Some chemicals can also cause diarrhea. Escherichia coli enteritis should be distinguished from the following diseases.

Bacterial dysentery

Caused by Shigella, diarrhea with pus or mucus is more common, less, and often have urgency and heavy, mostly cold and heat. A large number of pus red blood cells and phagocytic cells can be found in stool microscopy. Infant poisoning bacillary dysentery or atypical bacillary dysentery should be identified by pathogenic diagnosis.

2. Vibrio cholerae

After the infection, severe diarrhea occurs first and then vomiting, rarely nausea, vomit and diarrhea stools are rice-like watery, the amount is large, no urgency and heavy, a small number of patients have a small amount of blood. Dehydration is often caused by muscle pain, skin wrinkles, body surface temperature is lower than normal microscopic examination can be found that the extremely active Vibrio should be further cultured to identify the cupping network.

3. Vibrio parahaemolyticus food poisoning caused by Vibrio parahaemolyticus mainly due to eating food contaminated by the bacteria (more related to seafood), the onset of acute chills, paroxysmal abdominal pain (upper abdominal cramps) ) Start vomiting and diarrhea, mostly watery stools or bloody watery stools, mostly for the same meal, and should be identified by bacterial culture.

4. Salmonella food poisoning

Eating by food contaminated with Salmonella typhimurium caused by food. Acute onset, often accompanied by cold, abdominal pain, bloating, nausea, vomiting, diarrhea, watery stools and stench, early bacteremia, and more common morbidity. Rely on pathogens, serological diagnosis and identification.

5. Viral diarrhea

Diarrhea caused by enterovirus infection, characterized by highly infectious rotavirus small round virus and other infections in the early stage of vomiting, successive diarrhea, more watery stools and mucus, more common in autumn and winter, other viral diarrhea is more common in In summer and autumn, there are nausea and vomiting. In addition to gastrointestinal symptoms, there are often respiratory symptoms and pharyngitis, and palsy often involves the neck and back muscles. In the age of one year, children often see green watery or egg-like water. Antibiotic treatment is generally ineffective, and the course of disease is more than 5 to 7 days. Self-healing is further identified by serology and virus isolation.

6. Campylobacter enteritis

Campylobacter jejuni causes mild and viral enteritis, which is similar to ulcerative colitis or Crohn's disease. There is fever, diarrhea, watery or mucus-like, there will be bad odor, and there is pus and blood in the gallbladder color, and the bacillary tract is more than 1 week to restore the cupping net. Children often have abdominal cramps, and convulsions can occur when there is high fever. The incidence is mostly related to exposure to poultry, livestock or drinking unsterilized milk, raw water. Dark-field microscopic examination can find archery-like active bacteria, and bacterial culture is further diagnosed.

7. Yersinia enteritis

More common in children, related to food and water pollution. Abdominal pain, diarrhea, hypothermia, watery stool, may have sepsis, can be complicated by nodular erythema pseudo-appenditis, arthritis. Bacterial culture can be further identified.

8. Other

It should be noted that identification of diarrhea caused by Giardia and amoebic dysentery can be found in the fecal microscopic examination of amoeba or Giardia.

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