Viral enteritis - Causes, Symptoms, Diagnosis and Treatment
Viral enteritis - An acute infectious disease caused by viruses enterotropnymi, which can occur as an isolated lesion of the small intestine, or with the involvement of other organs and systems. The most common causative agents of viral enteritis is rotavirus, enterovirus, Coxsackie virus and ECHO. The source of infection - a sick person or carrier. Characteristic symptoms of intoxication, diarrhea syndrome, vomiting. The diagnosis is confirmed by the detection of the genetic material of a microorganism, and a fourfold increase in titer of specific antibodies. viral enteritis treatment is based on detoxification and symptomatic events. Specific antiviral therapy is not.
Viral enteritis
enteritis, gastroenteritis, gastroenterocolitis. In recent years there has been a trend for increased viral intestinal infections in the world. In developed countries, it is constantly recorded increase in the incidence, mainly among children and adolescents. A feature of the pathology is a long-term healthy virus carrier, in which a person has no symptoms, but serves as the source of infection. Pathogens may be in the intestine for several months, and are highly resistant in the environment. They can be stored for a long time in the water than that caused widespread outbreaks of viral enteritis. All of these factors combined with the variety of viruses enterotropnyh determine the high prevalence of disease.
rotaviruses and the genus Enterovirus (coxsackie viruses, ECHO, poliovirus, enterovirus 697173 7778 types). Also, viral enteritis can cause more than a hundred non-classified organisms, what is connected with the complexity of the diagnosis and the absence of specific treatment. All the pathogens are resistant to physical and chemical factors, including many disinfectants.
The source of infection with viral enteritis - people with clinical symptoms or virus infection. Especially dangerous is the patients with asymptomatic form. The spread of infection takes place contact-household (non-compliance with personal hygiene, poor hand washing after going to toilets), water (drinking contaminated water, especially open source) and alimentary route (in the use of contaminated products). Possible vertical transmission enterotropnyh virus (from mother to fetus), and the important role the hidden stream of viral enteritis in pregnant women.
For outbreaks of viral enteritis is characterized by the summer-autumn season. After recovery is maintained long-lasting immunity, but the variety of pathogens provides the possibility of repeated re-infection.
Penetrating into the gastrointestinal tract, microorganisms are introduced into the mucosa of the small intestine, where intense multiply and accumulate. Vital functions of virus results in the death of epithelial cells of the villi rejection. In the process of recovery of dead villi in viral enteritis gastrointestinal mucosa cells can not function properly, so the simple carbohydrates are not digested. The accumulation of these components in the intestinal lumen increases the osmotic pressure and leads to malabsorption of electrolytes, water and the development of diarrheal syndrome.
diarrhea. Stool thin, watery, frothy, without mucus and blood. In severe viral enteritis stool frequency can be up to twenty times a day. Reduced urine output. There are moderate persistent pain in the abdomen. These symptoms, in most cases accompanied by catarrhal symptoms: runny nose, nasal congestion, sore throat and pharynx hyperemia. Often the first days of a rash appears on the body, which then disappears. When erased form of viral enteritis symptoms are less pronounced and quickly pass. Of virus it has no clinical symptoms and can only be detected by laboratory methods.
Enteric viruses have affinity to many tissues of the human body, so often manifestations of the disease are not limited enteritis. The process may be involved the central nervous system, respiratory tract mucosa, conjunctiva of the eye, liver, heart and muscles.
In case of defeat oropharyngeal disease is accompanied by hyperemia of mucous, blisters on the bow of the tonsils. Viral conjunctivitis is characterized by redness eye, photophobia, lacrimation and minor hemorrhages. The defeat of the muscular system proceeds as polymyositis with soreness of different muscle groups. Cardio-vascular system in viral enteritis are possible signs of myocarditis and endocarditis (fatigue, palpitations, arrhythmias, and decreased blood pressure). Lymphotropic viruses (eg, adenovirus) lead to an increase in the lymph nodes. Enterovirus meningitis, encephalitis, accompanied by headache, nausea, vomiting, convulsions, loss of consciousness.
gastroenterology and infectious diseases put, given the peculiarities of the clinical course of the disease and the epidemiological situation in the region. On examination, the patient is determined by the pallor of the skin, decreased skin turgor, dry tongue. Enteritis caused by adenovirus, is characterized by an increase in the different groups of lymph nodes. In the clinical analysis of blood in viral enteritis elevated white blood cell count and erythrocyte sedimentation rate. In coprogram determined undigested fiber, starch grains and neutral fats; research on goiter reveals low levels of bifidobacteria, lactobacilli.
In order to detect specific immunoglobulins and direct causative agent of viral enteritis conducted serological and virological research, but they take a few days to not allow to distinguish of virus from an acute symptomatic forms. More important diagnostic criterion for acute phase of viral enteritis - a four-fold increase in antibody titer in paired sera and detection of RNA or DNA of the virus by polymerase chain reaction (PCR). Differential diagnosis of viral enteritis performed with intestinal poisoning, influenza, acute respiratory infections of enterovirus etiology is not, meningococcal meningitis and tuberculosis, rubella, measles and other diseases, depending on the prevailing syndrome.
Gastroenterology considers detoxification and symptomatic measures. In milder forms of treatment on an outpatient basis, in severe cases with severe dehydration - in conditions of infectious hospital. Diet therapy in viral enteritis involves the exclusion of dairy products, carbohydrates (fruits and vegetables); It recommends liquid food rich in protein, vitamins and trace elements. Displaying excessive drinking (rehydron), with a strong fluid loss due to diarrhea and repeated vomiting held rehydration infusion (intravenously administered solutions which replace water and electrolytes lost).
Appointed by immunomodulatory drugs, interferons, chelators. In the case of hyperthermia, severe muscle pain and headache in viral enteritis applied analgesics and antipyretic drugs. To normalize the microflora used probiotics (preparations containing useful intestinal bacteria) and prebiotics (substances that create favorable conditions for the settlement of Flora).
Prediction and prevention of viral enteritis
With timely treatment favorable prognosis. At strong dehydration may develop complications such as renal and cardiovascular failure. In the case of significant decrease of immunity, presence of concomitant diseases viral enteritis becomes severe course, especially if the pathogen has affinity for the central nervous system.
Prevention of viral enteritis is in compliance with personal hygiene, thorough washing of fruits and vegetables consumed raw, drinking only purified water, restriction of visiting crowded places during epidemics and regular restorative procedures. A sick family member enteritis virus should be isolated in a separate room and use individual dishes and towels. Specific prophylaxis of viral intestinal infections (vaccination) is not developed.