166.2 📚 國考版

166.2.0.1 必背 — 5 倧食物䞭毒 incubation

  1. 1-6 hr → S. aureus / B. cereus emetic (pre-toxin)
  2. 8-16 hr → C. perfringens / B. cereus diarrheal
  3. 16-72 hr → Salmonella, Shigella, ETEC, norovirus
  4. 2-7 d → Campylobacter, Yersinia, STEC
  5. 12+ hr → C. botulinum (toxin neurotoxin)

166.2.0.2 必背 — Non-inflammatory vs Inflammatory

項目 Non-inflammatory Inflammatory
䞻芁 氎瀉 血䟿 + mucus
機蜉 Toxin (cAMP) Invasion + cytotoxin
郚䜍 小腞 倧腞
燒 無 有
Fecal WBC - +
Pathogens ETEC, V. cholerae, S. aureus, B. cereus, norovirus Shigella, Salmonella, Campy, EHEC, EIEC, CDI

166.2.0.3 必背 — STEC NO ANTIBIOTIC

  • E. coli O157:H7 (+ non-O157)
  • Antibiotic → ↑ Shiga toxin release → HUS 颚險 ↑
  • 䞍芁 give FQ, TMP-SMX
  • 䞀埋 supportive + monitor for HUS

166.2.0.4 必背 — 䜕時 絊 antibiotic

  • Dysentery + 燒 + WBC ≥ + immunocompromise + 旅遊 / outbreak / severe
  • Cholera, CDI, Typhoid → always abx
  • Healthy non-typhoidal Salmonella → 䞍 abx

166.2.0.5 必背 — Traveler’s Self-Tx

  • Azithromycin 1 g × 1 (Asia 因 Campylobacter macrolide-S, FQ-R)
  • Rifaximin
  • ORS

166.2.0.6 必背 — Loperamide

  • 適: non-bloody afebrile mild
  • 犁: 血䟿, 燒, STEC suspected