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Detailed information of ENTEROTOXIGENIC COLITIS
ENTEROTOXIGENIC COLITIS
DEFINITION:
A bacterial infection of the colon caused by Enterotoxigenic E.
coli (ETEC) resulting in a secretory diarrhea.
EPIDEMIOLOGY:
- incidence: 1-3% of diarrhea, 10-30% in developing countries
- risk factors:
- age: all ages
- season: warm seasons
- route: indirect: food, water (large inoculum needed)
- environ: traveler's diarrhea
- incubation period: 2 days
PATHOGENESIS:
- Enterotoxigenic E. coli is a gram negative rod
- serotypes 06, 08, 015, 020, 025, 027, 063, 078, 080, 085,
0115, 0128ac, 0139, 0148, 0153, 0159, and 0167 - produce two
major enterotoxins:
- related to the Vibrio cholerae toxin
- stimulates adenylate cyclase -> increases cAMP
2. Heat-Stable (ST)
- related to toxin produced by some strains of Y.
enterocolitica
- stimulates guanylate cyclase -> increases cGMP
- possess adherence factors (fimbria) allowing the
ETEC to adhere tightly to the intestinal epithelium with
the help of several colonization factor antigens (CFA)
- genes for both CFA & enterotoxins are encoded on
same plasmid
CLINICAL FEATURES:
- explosive watery diarrhea, no cells
- lasts up to 5 days
- associated symptoms: abdominal pain, nausea/vomiting, little
or no fever, malabsorption
INVESTIGATIONS:
- culture - ELISA +, DNA probes, toxin assays
2. Biopsy
- ETEC cause little or no structural alterations to the gut
mucosa
MANAGEMENT:
- oral rehydration fluid (ORF) or intravenous rehydration
- TMP-SMX (if travelled to developing country)
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Pediatric Database - ENTEROTOXIGENIC COLITIS
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