Symptoms of food poisoning

The incubation period is from 2 hours to 1 day; at food toxic infections of staphylococcal etiology - up to 30 min. The acute period of the disease is from 12 hours to 5 days, after which the period of convalescence comes. Symptoms of food toxic infections are characterized by the prevalence of general intoxication, dehydration and gastrointestinal syndrome.

Classification of foodborne diseases

• By the prevalence of the lesion:
  • gastritis variant;
  • gastroenteric variant;
  • gastroenterocolitis variant.
• By the severity of the current:
  • lung;
  • moderate;
  • heavy.
• For complications:
  • uncomplicated:
  • complicated foodborne disease.

The first symptoms of food poisoning are abdominal pain, nausea, vomiting, chills, fever, loose stools. The development of acute gastritis is indicated by a white tongue overlaid with white; vomiting (sometimes indomitable) eaten on the eve of food, then - mucus with an admixture of bile; severity and pain in the epigastric region. 4-5% of patients show only signs of acute gastritis. Pain in the abdomen can have a diffuse character, be cramped, rarely - permanent. The development of enteritis is indicated by diarrhea, which occurs in 95% of patients. Stools are abundant, watery, fetid, light yellow or brown; have the appearance of marsh mud. The abdomen is soft, painful not only in the epigastric region, but also in the navel. The frequency of acts of defecation reflects the severity of the course of the disease. Symptoms of colitis: painful cramping pain in the lower abdomen (more often on the left), an admixture of mucus, blood in the bowel movement - is found in 5-6% of patients. In the gastroenterocolitis variant, sequential involvement of the stomach, small and large intestine in the pathological process is observed.

Fever is expressed in 60-70% of patients. It can be subfebrile; in some patients reaches 38-39 ° C, sometimes - 40 ° C. The duration of the fever is from a few hours to 2-4 days. Sometimes (with staphylococcal intoxication) - observe hypothermia. Clinical symptoms of foodborne toxic infections - pallor of the skin, shortness of breath, muscle weakness, chills, headache, joint and bone pain, tachycardia, arterial hypotension. According to the severity of these symptoms, a conclusion is drawn about the severity of the course of food poisoning.

The development of dehydration is evidenced by thirst, dry skin and mucous membranes, decreased skin turgor, pointed facial features, eyelid gland Westernization, pallor, cyanosis (acrocyanosis), tachycardia, arterial hypotension, decreased diuresis, muscle cramps of limbs.

From the cardiovascular system, note the deafness of cardiac tones, tachycardia (less often - bradycardia), arterial hypotension, diffuse changes of a dystrophic nature on the ECG (decrease of the T wave and depression of the ST segment). Changes in the kidneys are due to both their toxic damage and hypovolemia. In severe cases, it is possible to develop prerenal acute renal failure with oligoanuria, azotemia, hyperkalemia and metabolic acidosis.

Changes in hematocrit and specific gravity of the plasma make it possible to assess the degree of dehydration.

Intoxication and dehydration lead to severe impairment of the functions of internal organs and exacerbation of concomitant diseases: the development of hypertensive crisis, mesenteric thrombosis, acute impairment of cerebral circulation in patients with hypertensive disease, myocardial infarction in patients with ischemic heart disease, withdrawal syndrome or alcoholic psychosis in patients with chronic alcoholism.

Staphylococcal food poisoning causes enterotoxigenic strains of pathogenic staphylococci. They are resistant to environmental factors, carry high concentrations of salt and sugar, but die when heated to 80 ° C. Staphylococcus enterotoxins can withstand heating to 100 ° C for 1-2 hours. In appearance, taste and smell, foods contaminated with staphylococcus are indistinguishable from benign. Enterotoxin is resistant to the action of digestive enzymes, which makes it possible to absorb it in the stomach. It affects the parasympathetic nervous system, contributes to a significant reduction in blood pressure, activates the motility of the stomach and intestines. The onset of the disease is acute, violent. The incubation period is from 30 minutes to 4-6 hours. Intoxication is pronounced, the body temperature is usually increased to 38-39 ° C, but can be normal or decreased. Characterized by intense pain in the abdomen, localized in the epigastric region. They also note weakness, dizziness, nausea. In 50% of patients observed multiple vomiting (within 1-2 days), diarrhea (for 1-3 days). In severe cases, there is acute gastroenteritis (acute gastroenterocolitis). Characteristic tachycardia, deafness of heart sounds, arterial hypotension, oliguria. A short-term loss of consciousness is possible.

In the vast majority of patients, foodborne toxicosis ends in recovery, but in weakened patients and elderly people, pseudomembranous colitis and staphylococcal sepsis may develop. The most serious complication is ITH.

Food poisoning with clostridium toxin occurs after consuming products contaminated with clostridia and containing their toxins. Clostridium is found in soil, stools of people and animals. Poisonings are caused by the use of contaminated meat products of home cooking, meat and fish canned food. The disease is characterized by a severe course, high lethality. Toxins damage the intestinal mucosa, impair absorption. Upon entering the blood, toxins are bound to mitochondria of liver, kidney, spleen, lungs, the vascular wall is damaged and hemorrhages develop.

Clostridiosis occurs in the form of acute gastroenterocolitis with signs of intoxication and dehydration. The incubation period is 2-24 hours. The disease begins with intense, stitching pains in the abdomen. In mild and moderate flow, increase in body temperature, multiple vomiting, loose stools (up to 10-15 times) with an admixture of mucus and blood, abdominal tenderness during palpation. Duration of the disease 2-5 days.

The following variants of heavy current are possible:

• acute gastroenterocolitis: marked signs of intoxication: icterus of the skin; vomiting, diarrhea (more than 20 times a day), an admixture of mucus and blood in the feces; Sharp tenderness of the abdomen during palpation. Enlargement of the liver and spleen; decrease in the number of erythrocytes and hemoglobin, increase in the concentration of free bilirubin. With the progression of the disease - tachycardia, arterial hypotension, anaerobic sepsis, ITH;
• 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 a characteristic stool such as meat slops.

Cereosis in most patients is easy. The clinical picture is dominated by symptoms of gastroenteritis. Severe course is possible in elderly people and in immunodeficient conditions. Some cases of ITH with a lethal outcome are known.

Klebsiellosis is characterized by an acute onset with an increase in body temperature (within 3 days) and signs of intoxication. The clinical picture is dominated by acute gastroenterocolitis, less often - colitis. The duration of diarrhea is up to 3 days. The moderate course of the disease predominates. It is most severe in people with concomitant diseases (sepsis, meningitis, pneumonia, pyelonephritis).

In most cases, the proteosis proceeds easily. The incubation period is from 3 hours to 2 days. The main symptoms are weakness, intense, unbearable pain in the abdomen, sharp soreness and loud rumblings, stinking feces. Cholera-like and shigellose-like variants of the disease course, leading to the development of ITSH, are possible.

Streptococcal food-borne toxicoinfection is characterized by an easy flow. The main symptoms are diarrhea, abdominal pain.

A little-studied group of foodborne toxic infections - aeromonosis, pseudomonas, cytobacteriosis. The main symptoms of food toxic infections are gastroenteritis of varying severity.

[1], [2], [3],

Complications of food poisoning

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

The main causes of death were myocardial infarction and acute coronary insufficiency (23.5%), thrombosis of mesenteric vessels (23.5%), acute cerebrovascular accident (7.8%), pneumonia (16.6%). ITSH (14.7%).

[4], [5]