Symptoms of food toxic infections

The incubation period is from 2 hours to 1 day; in case of food toxicoinfections of staphylococcal etiology - up to 30 minutes. The acute period of the disease is from 12 hours to 5 days, after which the recovery period begins. Symptoms of food toxicoinfections are characterized by the predominance of general intoxication, dehydration and gastrointestinal syndrome.

Classification of food poisoning

• By prevalence of the lesion:
  • gastritis variant;
  • gastroenteric variant;
  • gastroenterocolitic variant.
• By severity of the course:
  • lung;
  • moderate;
  • heavy.
• By complications:
  • uncomplicated:
  • complicated food poisoning.

The first symptoms of food poisoning are abdominal pain, nausea, vomiting, chills, fever, and loose stools. Acute gastritis is indicated by a tongue coated with a white coating; vomiting (sometimes uncontrollable) of food eaten the day before, then mucus mixed with bile; heaviness and pain in the epigastric region. In 4-5% of patients, only signs of acute gastritis are detected. Abdominal pain can be diffuse, cramping, or, less often, constant. Diarrhea, which occurs in 95% of patients, indicates the development of enteritis. Stool is abundant, watery, foul-smelling, light yellow or brown in color; it looks like swamp mud. The abdomen is soft on palpation, painful not only in the epigastric region, but also in the navel area. The frequency of bowel movements reflects the severity of the disease. Signs of colitis: excruciating cramping pain in the lower abdomen (usually on the left), mucus and blood in the stool - are found in 5-6% of patients. In the gastroenterocolitic variant, the stomach, small intestine and large intestine are consistently involved in the pathological process.

Fever is expressed in 60-70% of patients. It can be subfebrile; in some patients it reaches 38-39 °C, sometimes - 40 °C. The duration of fever is from several hours to 2-4 days. Sometimes (with staphylococcal intoxication) - hypothermia is observed. Clinical symptoms of food toxic infections - pale skin, shortness of breath, muscle weakness, chills, headache, pain in the joints and bones, tachycardia, arterial hypotension. Based on the severity of these symptoms, a conclusion is made about the severity of the course of food toxic infection.

The development of dehydration is indicated by thirst, dry skin and mucous membranes, decreased skin turgor, sharpened facial features, sunken eyeballs, pallor, cyanosis (acrocyanosis), tachycardia, arterial hypotension, decreased diuresis, and muscle cramps in the extremities.

From the cardiovascular system, muffled heart sounds, tachycardia (less often bradycardia), arterial hypotension, diffuse dystrophic changes on the ECG (reduction of the T wave and depression of the ST segment) are noted. Changes in the kidneys are caused by both toxic damage and hypovolemia. In severe cases, prerenal acute renal failure with oligoanuria, azotemia, hyperkalemia and metabolic acidosis may develop.

Changes in hematocrit and plasma specific gravity allow one to assess the degree of dehydration.

Intoxication and dehydration lead to severe dysfunction of internal organs and exacerbation of concomitant diseases: development of hypertensive crisis, mesenteric thrombosis, acute cerebrovascular accident in patients with hypertension, myocardial infarction in patients with coronary heart disease, withdrawal syndrome or alcoholic psychosis in patients with chronic alcoholism.

Staphylococcal food poisoning is caused by enterotoxigenic strains of pathogenic staphylococci. They are resistant to environmental factors, tolerate high concentrations of salt and sugar, but die when heated to 80 °C. Staphylococcal enterotoxins can withstand heating to 100 °C for 1-2 hours. In appearance, taste and smell, products contaminated with staphylococcus are indistinguishable from benign ones. Enterotoxin is resistant to digestive enzymes, which makes it possible for it to be absorbed in the stomach. It affects the parasympathetic nervous system, promotes a significant decrease in blood pressure, and activates the motility of the stomach and intestines. The onset of the disease is acute, stormy. The incubation period is from 30 minutes to 4-6 hours. Intoxication is pronounced, body temperature is usually elevated to 38-39 °C, but can be normal or low. Characteristic is intense abdominal pain localized in the epigastric region. Weakness, dizziness, nausea are also noted. 50% of patients experience repeated vomiting (for 1-2 days), diarrhea (for 1-3 days). In severe cases, acute gastroenteritis (acute gastroenterocolitis) occurs. Characteristic are tachycardia, muffled heart sounds, arterial hypotension, oliguria. Short-term loss of consciousness is possible.

In the vast majority of patients, food poisoning ends in recovery, but in weakened patients and the elderly, pseudomembranous colitis and staphylococcal sepsis may develop. The most severe complication is ISS.

Clostridium toxin food poisoning occurs after eating foods contaminated with clostridia and containing their toxins. Clostridia are found in soil, human and animal feces. Poisoning is caused by eating contaminated home-cooked meat products, canned meat and fish. The disease is characterized by a severe course and high mortality. Toxins damage the intestinal mucosa and disrupt absorption. When entering the blood, toxins bind to the mitochondria of liver, kidney, spleen, and lung cells, damaging the vascular wall and causing hemorrhages.

Clostridiosis occurs as acute gastroenterocolitis with signs of intoxication and dehydration. The incubation period is 2-24 hours. The disease begins with intense, stabbing pain in the abdomen. In mild and moderate cases, there is an increase in body temperature, repeated vomiting, loose stools (up to 10-15 times) with mucus and blood, and abdominal pain upon palpation. The duration of the disease is 2-5 days.

The following severe course variants are possible:

• acute gastroenterocolitis: pronounced signs of intoxication: yellowing of the skin; vomiting, diarrhea (more than 20 times a day), mucus and blood in the stool; severe abdominal pain upon palpation. enlarged liver and spleen; decreased red blood cell count and hemoglobin content, increased free bilirubin concentration. As the disease progresses - tachycardia, arterial hypotension, anaerobic sepsis, ISS;
• cholera-like course - acute gastroenterocolitis in combination with dehydration of I-III degree;
• development of necrotic processes in the small intestine, peritonitis against the background of acute gastroenterocolitis with characteristic stools like meat slops.

Cereosis is mild in most patients. The clinical picture is dominated by symptoms of gastroenteritis. Severe course is possible in elderly people and in immunodeficiency states. There are isolated cases of ITS with a fatal outcome.

Klebsiella is characterized by an acute onset with an increase in body temperature (within 3 days) and signs of intoxication. Acute gastroenterocolitis dominates in the clinical picture, less often - colitis. Duration of diarrhea is up to 3 days. Moderate course of the disease prevails. It is most severe in people with concomitant diseases (sepsis, meningitis, pneumonia, pyelonephritis).

Proteosis in most cases is mild. The incubation period is from 3 hours to 2 days. The main symptoms are weakness, intense, unbearable pain in the abdomen, sharp pain and loud rumbling, foul-smelling stools. Cholera-like and shigellosis-like variants of the disease are possible, leading to the development of ITS.

Streptococcal food poisoning is characterized by a mild course. The main symptoms are diarrhea and abdominal pain.

A poorly studied group of food toxic infections - aeromoniasis, pseudomoniasis, citrobacteriosis. The main symptoms of food toxic infections are gastroenteritis of varying severity.

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Complications of food poisoning

• Infectious toxic shock.
• Regional circulatory disorders:
  • coronary (myocardial infarction);
  • mesenteric (thrombosis of mesenteric vessels);
  • cerebral (acute and transient cerebrovascular accidents).
• Pneumonia.
• Acute renal failure.

The main causes of death are myocardial infarction and acute coronary insufficiency (23.5%), mesenteric vascular thrombosis (23.5%), acute cerebrovascular accidents (7.8%), pneumonia (16.6%), and ITS (14.7%).

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