GIT Infection &

Typhoid Fever
• The etiology of infectious diarrhea includes bacteria, viruses, and
protozoans. Viral infections are the leading cause of diarrhea in the
world.

• Fluid and electrolyte replacement is the cornerstone of therapy. Oral

rehydration therapy is preferred in most cases of mild and moderate
diarrhea. The necessary components of oral replacement therapy are
glucose, sodium, potassium, chloride, and water.
• Antimicrobial therapy often is not indicated for enteritis because
many cases are mild and self-limited or are viral in nature. Diarrheal
illness can be prevented by following simple rules of personal hygiene
and safe food preparation.

• The most common pathogens for traveler’s diarrhea include

enterotoxigenic Escherichia coli, Shigella, Campylobacter, Salmonella,
and viruses.
• Patient education and prevention strategies are important in
preventing and treating traveler’s diarrhea. Prophylaxis with
antibiotics is not recommended in most situations.

• Common pathogens responsible for food poisoning include

Staphylococcus, Salmonella, Shigella, and Clostridium.
Pharmacologic Treatment
• Rehydration
• Antimotility
• Probiotics
• Antibiotics
TYPHOID FEVER
• Enteric fever
• Salmonella enterica serovar
Typhi (S typhi)
• Gram negative bacterium
• Less severe
• S paratyphi A
• S paratyphi B (Schotmulleri)
• S paratyphi C (Hirschfeldii)
 Figure 3

The Lancet Global Health 2014 2, e570-e580DOI: (10.1016/S2214-109X(14)70301-8)

Copyright © 2014 Mogasale et al. Open Access article distributed under the terms of CC BY-NC-SA
Terms and Conditions
 Figure 2

The Lancet Global Health 2014 2, e570-e580DOI: (10.1016/S2214-109X(14)70301-8)

Copyright © 2014 Mogasale et al. Open Access article distributed under the terms of CC BY-NC-SA
Terms and Conditions
Mortality causes
Bhutta, BMJ 2006;333:78–82
Bhutta, BMJ 2006;333:78–82
Differential diagnosis
• Acute gastroenteritis
• Bronchitis
• Bronchopneumonia
• Malaria
• Sepsis with other bacterial pathogens
• Infections caused by intracellular organisms
• E.g. tuberculosis, brucellosis, tularaemia, leptospirosis, and rickettsial diseases
• Viral infections
• E.g. dengue fever, acute hepatitis, and infectious mononucleosis
Bhutta, BMJ 2006;333:78–82
• Ciprofloxacin
• Not for use in pregnant patients or children
• Levofloxacin, ceftriaxone, cefotaxime
• Some penicillin-allergic patients may react to cephalosporins
• Trimethoprim–sulfamethoxazole

• In Indonesia: chloramphenicol
• Bone marrow toxicity in infants
• Grey baby syndrome
Thanks