II. Epidemiology
- Natural Hosts: Wild and domestic mammals, birds
-
Waterborne Illness source
- Natural waters in which E. coli is not present
III. Pathophysiology
- Grows at refrigerator Temperatures
- Causes Mesenteric Lymphadenitis (mimics Appendicitis)
IV. Differential Diagnosis
V. Labs
- Stool Culture on selective growth medium
VI. Management
- Indications
- Severe disease
- Bacteremia
- Antibiotics not needed in mild disease or uncomplicated enteritis
- Severe disease - first line regimen (combined Doxycycline with Aminoglycoside)
- Doxycycline 100 mg IV twice daily AND
- Gentamicin or Tobramycin 5 mg/kg/day every 24 hours
- Severe disease - alternative regimens
- Trimethoprim-Sulfamethoxazole (TMP-SMZ) DS 160/180 mg twice daily for 5 days
- Ciprofloxacin 500 mg orally twice daily for 7-10 days
- References
- Gilbert (2013) Sanford Guide