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home - Colon - Colonic Infection - Calcivirus 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.

Calcivirus

Diagnosis -It is not needed clinically.For outbreaks RT-PCR is often used.Immunoassay using sera generated against VLPs or monoclonal antibodies(less se and sp than PCR) ca be used. SapovirusSporadic gastroen-teritis in young children Causes > 90 % of viral gastroenteritis outbreaks in west.Most common cause of foodborne disease . Seasonality — Usually called "winter vomit-ing disease" but actually doesnt vary with season Febrile illness Moderate D+ prominent VHeadache Constitutional symptoms. Incubation period of 24 to 48hrs ABRUPT ONSET 12 to 60 hours with a full and rapid recovery Viral shedding This can persist for weeks after symptom resolution but transmission usually occurs in symptomatics only. Norovirus Person-person/ Surfaces Airborne Spread: Food- borne Pathological features:-Loss of brush border enzymes.-The direct effect GI toxicof the rotavirus enterotoxin NSP4.-An enteric nervous system activa-tion by infection with subsequent fluid and electrolyte secretion. -Patchy irregularities of duodenum and jejunumShortened and blunted villi-Increased infiltration of the lamina propria with mononuclear cells. -Rotavirus particles in the epithelial cells. -Patches resolve. Host susceptibility:Patients with blood group A and O (GI).Patients with blood group A and B (GII). Sapovirus Calciviruses Calciviruses Noroviruses Sapoviruses Subtypes:GIGIIGIIIGIV GV Subtypes:GIGIIGIIIGIV GV ssRNA with one major (VP1) and one minor (VP2) capsid protein Genera The features of NorovirusThe incubation period is 24-48 hrs.The duration of illness is 12-60 hours.Vomiting occurs in 50%.Stool cultures are -ve for bacterial pathogens. Written by Dr Sebastian Zeki

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