Symptoms of Escherichiosis

Symptoms of escherichiosis depend on the type of pathogen, the age of the patient, and the immune status.

Clinical classification of Escherichiosis

• By etiological signs:
  • enterotoxigenic;
  • enteroinvasive;
  • enteropathogenic;
  • enterohemorrhagic;
  • entero-adhesive.
• By the form of the disease:
  • gastroenteric;
  • enterocolitis;
  • gastroenterocolitis;
  • generalized (coli-sepsis, meningitis, pyelonephritis, cholecystitis).
• By the severity of the current:
  • lung;
  • of moderate severity;
  • heavy.

With escherichiosis caused by enterotoxigenic strains, the incubation period is 16-72 hours, for which a cholera-like course of the disease occurs, with a lesion of the small intestine without a pronounced syndrome of intoxication ("travelers' diarrhea").

Escherichiosis begins acutely, patients are troubled by weakness, dizziness. Body temperature normal or subfebrile. There are typical symptoms of escherichiosis: nausea, repeated vomiting, diffuse cramping pains in the abdomen. The chair is frequent (up to 10-15 times a day), liquid, copious, watery, often resembling a rice broth. The abdomen is inflated, palpation is determined by rumbling, a slight spill of soreness. The severity of the flow is determined by the degree of dehydration. A lightning-fast form of the disease with rapid development of exsicosis is possible. Duration of the disease is 5-10 days.

Enteroinvazivnye escherichia cause dysentery-like disease, which occurs with symptoms of general intoxication and primary lesion of the colon. The incubation period is 6-48 hours. The onset is acute, with an increase in body temperature to 38-39 ° C, chills, weakness, headache, muscle pain, worsening of appetite. In some patients, body temperature is normal or subfebrile. After several hours, the following symptoms of escherichiosis join: cramping pains, mainly in the lower abdomen, false desires for defecation, tenesmus, loose stools, usually of a fecal nature, up to 10 or more times a day with an admixture of mucus and blood. With a more severe course of the disease, a chair in the form of a "rectal spitting". Sigma is spasmodic, densified and painful. With sigmoidoscopy - catarrhal, less often - catarrhal-hemorrhagic or catarrhal-erosive proctosigmoiditis. The course of the disease is benign.

Fever lasts 1-2, rarely 3-4 days, the disease - 5-7 days. After 1-2 days, the stool is normalized. Spasm and soreness of the colon persist for 5-7 days. Restoration of the mucous membrane of the colon comes to the 7-10th day of the disease.

In children, enteropathogenic Escherichiosis, caused by E. Coli of the 1st class, proceeds in the form of various severity of enteritis, enterocolitis, and in neonates and premature babies - in a septic form. The intestinal form observed in children is characterized by an acute onset of the disease, body temperature 38-39 ° C, weakness, vomiting, watery diarrhea, stools of yellow or orange color. Quickly develops toxicosis and exsicosis, body weight decreases. The septic form of the disease has severe symptoms of escherichiosis and intoxication (fever, anorexia, regurgitation, vomiting). There are multiple purulent foci.

Enteropathogenic Escherichiosis, caused by E. Coli, 2nd class, is recorded in adults and children. The incubation period is 1-5 days. Characterized by an acute onset of the disease (body temperature 38-38.5 ° C, chills, infrequent vomiting, abdominal pain, stool without pathological impurities, liquid, up to 5-8 times a day), benign course. Some patients report hypotension, tachycardia.

With escherichiosis caused by enterohemorrhagic strains, the disease manifests itself as a syndrome of general intoxication and a lesion of the proximal part of the large intestine. The incubation period is 1-7 days. Symptoms of Escherichiosis begin acutely: with pain in the abdomen, nausea, vomiting. Body temperature is subfebrile or normal, the stool is liquid, up to 4-5 times a day, without any admixture of blood. The condition of patients worsens on the 2nd-4th day of the illness, when the stool becomes more frequent, there is an admixture of blood, tenesmus. Endoscopic examination reveals catarrhal-hemorrhagic or fibrinous-ulcerative colitis. More pronounced pathomorphological changes are found in the cecum. The disease, caused by the strain 0157: H7, is most severe. 3-5% of patients develop hemolytic-uremic syndrome (Gasser's syndrome) 6-8 days after the onset of the disease, which is manifested by hemolytic anemia, thrombocytopenia, progressive arthritis and toxic encephalopathy (convulsions, paresis, sopor, coma). The lethality in these cases can be 3-7%. Gasser's syndrome is more common in children under 5 years old.

Features of Escherichiosis caused by entero-adhesive strains have been studied little. The disease is recorded in patients with a weakened immune system. Often identify extra-intestinal forms - the defeat of the urinary (pyelonephritis, cystitis) and bile excreting (cholecystitis, cholangitis) ways. Possible septic forms (coli-sepsis, meningitis).

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Complications of Escherichiosis

More often, escherichiosis is benign, but complications are possible: IHT, hypovolemic shock with dehydration of III-IV degree, arthritis, sepsis, pneumonia, pyelocystitis, pyelonephritis, cholecystitis, cholangitis, meningitis, meningoencephalitis. Lethal outcome as a result of OPN (Gasser's syndrome) is recorded in children under 5 years in 3-7% of cases. In Moscow over the past 10 years there have been no lethal outcomes.

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