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home - Colon - Colonic Infection - E. coli EHEC 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.

E. coli EHEC

Attachment events —The adhesin(s) mediates the initial attachment of EHEC to intesti-nal epithelial cells and produce "attaching-effacing" lesions on individual intestinal epithelial cells.Also done by EPEC. Secretes shiga like toxin The toxins travel from Golgi to the E.R. where they destroy ribosomes by the removal of a single adenine residue from the 28SrRNA. This results in the death of the cell. -EPEC-EIEC-ETEC-EHEC-EAEC E. coli -The H antigen This is defined serologically by the antigenic specificity of the bacterial flagellum. -The O antigen This is defined serologically and dete-mined by the repeating polysaccharide chains that are part of the lipopolysac-charide (LPS) embedded in the outer leaflet of the outer membrane. -Strains of E. coli can be classified by their O and H antigens.- EpidemiologyE.coli survives readily in water and food supplies in the developing world.It is a common bacterial cause of dehydrating diarrheal illness in children <2 years and traveller’s diarrhoea. Written by Dr Sebastian Zeki Little or no systemic dissemination Phagocytosis by neutrophils and macrophages Lumen E. coli Dysentery Epithelial cell extrusion Micro-ulcers Endocytosis Columnar eoithelial cells of the small intestine Vacuole lysis Spread Multiplication Cel death Regeneration of epithelium Superf-cial tissue invasion Lamina propria Rad & white ells, mucous, cell debris, bascteria DNA Cytoplasm Cell membrane Flagellum Polysaccharide Outer membrane Peri- Cytoplasmic membrane K capsule O-Antigen of LPS Lipid A of liposaccharide (LPS)

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