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NR 602 Midterm Study Guide Topics 26-30: Cryptosporidium

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  • Overview: Cryptosporidium is a parasite that causes cryptosporidiosis, a type of gastroenteritis leading to diarrhea and vomiting. While the infection typically resolves within a week or two in healthy individuals, it can be life-threatening for immunocompromised patients.
  • Symptoms:
    • Watery diarrhea
    • Dehydration
    • Lack of appetite
    • Weight loss
    • Stomach cramps
    • Fever
    • Nausea/Vomiting
    • Some individuals may be asymptomatic
  • Prevention: Good hand hygiene, washing fruits and vegetables, avoiding fecal exposure, and avoiding contaminated water.

Pyloric Stenosis

  • Overview: Pyloric stenosis is caused by hypertrophy of the pyloric muscle, resulting in narrowing of the pyloric sphincter. It commonly occurs in 3/1000 births, more often in males and first-born Caucasian males, and may be linked to erythromycin administration in the first weeks of life.
  • Symptoms:
    • Regurgitation and non-projectile vomiting in the first few weeks of life
    • Projectile vomiting by 2 to 3 weeks of age
    • Insatiable appetite with weight loss
    • Dehydration and constipation
  • Physical Exam:
    • Weight loss
    • Vomiting, potentially containing blood
    • A palpable “olive” mass in the epigastrium to the right of the midline
    • Reverse peristalsis
  • Diagnostics:
    • Ultrasound (US)
    • Upper GI series showing a “string sign”
  • Management: Surgery (Pyloromyotomy) following correction of fluid balance. Prognosis is excellent.

Intussusception

  • Overview: Intussusception is a frequent cause of intestinal obstruction in children, particularly those between 5 to 10 months of age. It can also be associated with underlying medical conditions in older children, including polyps, Meckel diverticulum, and others.
  • Symptoms:
    • Intermittent colicky abdominal pain
    • Vomiting
    • Bloody mucous stools (“currant jelly” stools)
    • Episodes of screaming and drawing legs up, with periods of calm or lethargy
    • History of upper respiratory infection (URI) is common
  • Physical Exam:
    • Glassy-eyed appearance between episodes
    • Sausage-like mass in the right upper quadrant (RUQ) with emptiness in the right lower quadrant (RLQ) (DANCE SIGN)
    • Distended and tender abdomen
    • Positive guaiac stools
  • Diagnostics: To be further detailed based on the presentation.