MedBugs: SAQ #339

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Case: Haemorrhagic colitis

You are the Emergency Consultant in a major referral centre. A 23 year old male presents with a 3 day history of diarrhoea and fever. The diarrhoea was initially watery, but has contained small volumes of fresh blood over the last 24 hours. He is opening his bowels over 20 times a day, has mild generalised abdominal pain and fever responding to paracetamol. He has not had any vomiting and continues to have good oral fluid intake, but is off his food. He has not had any recent travel, and never had an episode such as this in the past. He has no relevant past medical history, takes no regular medications, and has no allergies. T 37.8

BP 118/50
HR 115
RR 18
SpO2 100% RA

BSL 5.6

1. Name (5) bacteria known to cause haemorrhagic diarrhoea. 5 marks

2. List (2) clinical features which may make you consider the use of antibiotic treatment in any patient with enteritis who presents to hospital. 2 marks

Blood tests show Hb 102, WCC 21, PLT 45 Na 138 K 3.2 Urea 19 Creat 210

3. What is the most common cause of this man’s haemorrhagic colitis? 1 mark

4. List (2) treatments you would avoid in this patient and give your rationale. 2 marks

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Case: Haemorrhagic colitis

1. Name (5) bacteria known to cause haemorrhagic diarrhoea. 5 marks

2. List (2) clinical features which may make you consider the use of antibiotic treatment in any patient with enteritis who presents to hospital. 2 marks

3. What is the most common cause of this man’s haemorrhagic colitis? 1 mark

4. List (2) treatments you would avoid in this patient and give your rationale. 2 marks

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