Acute intestinal infections in children (AEI) are a large group of viral and bacterial diseases. In the structure of acute infections, intestinal infections rank second after acute respiratory infections. Young children are especially often and seriously ill. One third of all etiologically deciphered acute intestinal infections in children are shigellosis, or dysentery, another third is viral diarrhea, another third is OCI caused by opportunistic bacteria (UPB), and much less often salmonellosis, escherichiosis, yersiniosis, campylobacteriosis. Unfortunately, 50-70% of all acute intestinal infections in children remain etiologically undeciphered, they are called intestinal infections of unexplained etiology (CINE). For bacterial OCI, summer and autumn seasonality is characteristic, for viral ones, winter.
According to the mechanism of interaction, pathogens of acute intestinal infections are divided into non-invasive (cholera, AII caused by enteroinvasive E. coli - EIKP and various UPB), partially invasive (AII caused by enteropathogenic E. coli) and invasive (shigellosis, salmonobellosis), and campilobellosis.
Symptoms
In viral intestinal infections, the osmotic variant of diarrhea predominates, due to the defeat of mature enterocytes and impaired parietal digestion of disaccharides - lactose, sucrose, maltose. From a clinical point of view, it is more important to distinguish between watery (enteric) and invasive (colitis) forms of diarrhea. The first is due to the action of viruses, bacterial enterotoxins and is not accompanied by significant damage to the intestine, a severe inflammatory reaction. The second is associated with a pronounced inflammation of the colon and is a kind of marker of dysentery and other invasive diarrhea (salmonellosis, campylobacteriosis, yersiniosis).
Acute intestinal infection syndrome includes:
- intoxication in the form of fever, lethargy, malaise, blood circulation disorders, manifested by tachycardia, decreased blood pressure, pallor of the skin, the appearance of a honeycomb (marble) pattern on the skin and cold extremities in severe forms; in young children, severe intoxication can manifest as neurotoxicosis;
- vomiting and diarrhea, which can lead to dehydration, the development of toxicosis with exicosis.
Of the viral diarrhea occurring in children, rotavirus intestinal infections predominate. Children from 6 months to 3 years old are affected, and up to 80% of all cases of viral diarrhea occur not in the winter period. Characterized by watery diarrhea (enteritis), short-term infrequent vomiting (gastroenteritis) and short-term fever (3-5 days), as well as mild catarrhal changes in the pharynx, conjunctiva, runny nose. Diarrhea also occurs when infected with adenoviruses, enteroviruses, astroviruses, caliciviruses (toroviruses, viruses of the Norfolk group, Sapporo). Watery diarrhea or acute enteritis (gastroenteritis) can occur with many bacterial acute intestinal infections in children (salmonellosis, escherichiosis).
The stool in such patients is watery, sometimes in the form of slightly yellowish or whitish water (stool of the "rice water" type), abundant, may contain a small admixture of mucus. There are no pathological impurities (cloudy or green mucus, pus and blood streaks) in the stool. Often observed in patients with bloating, sometimes significant, rough rumbling in the abdomen. detectable on palpation, splashing, frothy yellow, sometimes orange stools.
With the development of bacterial intestinal infections in children in the clinical form of enterocolitis or colitis, there are always pathological impurities in the stool, the amount and composition of which varies significantly in different patients and even in separate portions of feces in one patient. With distal colitis (shigellosis), detritus may be absent in the stool, and it itself may consist only of pathological impurities (rectal spitting). In this case, there are abdominal pain during bowel movements, tenesmus, false desires are detected, anus gaping, sometimes due to strong straining (tenesmus) the rectal mucosa may fall out. Salmonellosis is characterized by a high content in the stool of green mucus such as "frog eggs", "swamp mud". In case of salmonellosis, campylobacteriosis, clostridiosis, sometimes there may be a significant admixture of bright blood in the stool of the "raspberry jelly" type.
Diagnostics
The diagnosis of acute intestinal infection in children is based on the clinical combination of general intoxication syndrome and diarrhea syndrome. The schematic diagram of the diagnostic algorithm is presented below:
- the infectious nature and possible etiology of the disease should be established;
- determine the belonging of an intestinal infection to one of two groups - invasive or secretory diarrhea in the pathogenesis;
- determine the level of damage - enteritis, enterocolitis, gastroenterocolitis, distal colitis);
- establish the severity of the disease (erased, mild, moderate, severe). The definition of severity is based on the severity of symptoms of intoxication and the degree of damage (local manifestations);
- to establish the form of OCI - localized (with localization only at the level of the entrance gate, i.e., intestines), generalized - typhoid (with the penetration of the pathogen into the blood) and septic (with extraintestinal foci) infection;
- to establish the stage of acute intestinal infection in children and its nature: the acute phase of the disease - the initial period, the peak period, the phase of convalescence; the disease can have a smooth, prolonged course - up to 1.5 months or chronic - more than 1.5 months, as well as a course with both relapses and / or prolonged bacterial excretion, and with the development of secondary functional post-infectious syndromes (fermentopathy, allergoenteropathy, dysbiosis);
- assess the age of children, other diseases;
- decide on the place of therapy for children with intestinal infection - a hospital or a home.
Treatment
With watery diarrhea, especially if a viral intestinal infection is suspected, antibiotics are not indicated, they are prescribed:
- a diet with limited sugar;
- sorbents;
- prebiotics (hilak-forte, frodo);
- biological products;
- sometimes enzyme preparations (pancreatin, mezim-forte, creon);
- oral detoxification and rehydration (with mild dehydration) in a volume of 20-50 ml / kg / day, fractionally.
Rehydration is carried out in the presence of dehydration in children in the volume of fluid, depending on the age, body weight of the children and the degree of dehydration established clinically.
With enterocolitis, colitis (invasive diarrhea), antimicrobial drugs are used orally, less often parenterally.
Bacteriophages can be used as a means of influencing the cause in milder forms of bacterial acute intestinal infections in children. They can also be used in the aftercare phase and in contact children.
The use of immune drugs may be useful: lysozyme, as well as KIP (complex immunoglobulin drug), targeted lactoglobulins and other immunomodulators.
With severe abdominal pain, tenesmus, myotropic antispasmodics (no-shpa, drotaverin, baralgin, spazgan) are prescribed. The rest of the therapy is the same as for viral intestinal infections in children.
With the development of secondary enteropathies, corrective therapy is necessary, in which an elimination diet for a long period is especially important.
Observation
The frequency of visits to children with acute intestinal infection depends on the severity of the disease, in the acute period, especially in children of the first year - every day. Identification of dehydration, neurotoxicosis, and other symptoms of severe intoxication is the basis for immediate hospitalization of the sick child.
Children left at home are monitored at a rate that depends on the severity of the disease (young children - every day). Children are discharged after recovery.
The article was prepared and edited by: surgeon Tags:,Intestinal infection- a large group of infectious diseases. An infection that occurs with damage to the gastrointestinal tract and diarrhea, as the main clinical symptom, is an intestinal infection.
Intestinal infection, symptoms - This is diarrhea, abdominal pain, nausea and vomiting. In the structure of infectious morbidity, intestinal infection ranks second, after respiratory diseases.
The epidemiological season of intestinal infections is May - October. However, in the cold season, intestinal infections are recorded, but already of viral etiology. These are: - intestinal flu, the causative agent is rotavirus;
- acute respiratory infections with intestinal syndrome, causative agents - respiratory viruses.
Intestinal infection, symptoms, etiological factors:
- bacteria (salmonella, shigella, enteropathogenic and hemolytic Escherichia coli, Yersinia, Staphylococcus aureus, etc.);
- viruses (rotavirus, enterovirus, parvovirus, etc.);
- protozoa (lamblia, amoeba, blastocysts, etc.).
The stages of intestinal infection include:
- the incubation period with a duration of 2-3 hours to 3-4 days is the time from the infection of the organism with the pathogen until the appearance of clinical symptoms;
- prodromal period - during this period the child is capricious, less active and it lasts a short time, literally a few hours, after which comes
- acute period of intestinal infection lasting up to two weeks; during this period, all the main clinical symptoms of the disease appear;
- with the normalization of body temperature and the termination of the leading symptoms (vomiting, diarrhea, etc.), the recovery period begins, which lasts up to 4 weeks.
But all this is individual and depends on the pathogenicity and dose of the pathogen, the adequacy and timeliness of treatment, the state of the immune system. During this period, the child is weakened and preventive measures are required in relation to airborne infections, the possibility of a second infection with a previous infection is not excluded.
When diagnosing "Intestinal infection", it is necessary to exclude:
- acute surgical pathology - acute appendicitis, the leading symptom of which is abdominal pain; although vomiting and fever are possible, but without diarrhea;
- lactase deficiency in children under 1 year old; it can be suspected by the following signs: liquid foamy stool, which can be frequent up to 8-10 times a day, or, conversely, rare and even absent without stimulation; the baby is restless during or after breastfeeding or formula feeding; bloating is observed;
- dyskinesia of the biliary tract or dysfunction of the pancreas; in these conditions, repeated vomiting is characteristic;
- intestinal dysbiosis, in which there may be loose stools, but no temperature; the condition is chronic.
Sources of intestinal infections: - patients and bacteria carriers.
Transmission mechanisms for bacterial and protozoal intestinal infections (read also the articles "Amoebic dysentery", "Dysentery in children"): - Fecal-oral and contact-household.
The causes of these diseases:
- dirty hands;
- poorly washed fruits and vegetables;
- food products with an expired shelf life;
- swimming in natural reservoirs;
- drinking unboiled water.
Prevention consists in eliminating these causes.
Viral intestinal infections are transmitted by airborne droplets during communication or contact with a patient or carrier, and the waterway of transmission of these infections is also characteristic.
Viral intestinal infections are characterized by:
- normal body temperature, which usually does not rise;
- diarrhea can be frequent, liquid, but short-term.
In most cases, patients with viral intestinal diseases do not require hospitalization.
Viral hepatitis A or Botkin's disease, in which:
- feces become light or white;
- urine becomes dark - the color of beer;
- yellowness of the skin and mucous membranes appears, especially the sclera of the eyes. The prognosis after adequate treatment with an infectious disease specialist is favorable.
Intestinal infection of unknown etiology (CINE) is the most common diagnosis when the causative agent of the infection cannot be identified. In these cases, acute intestinal infection (AEI) is often diagnosed with the following explanation:
- acute gastritis (vomiting and abdominal pain);
- acute enteritis (frequent watery diarrhea);
- acute colitis (unformed feces, blood and mucus in it, and tenesmus is also noted).
With a combination of signs, the terms gastroenteritis or enterocolitis are used.
To decipher the etiological nature of the disease, stool tests for bacteriological examination must be taken three times, that is, three chairs in a row. It is also necessary to pass an analysis of feces for microflora, where it is possible to determine the dilution titer, in which this or that bacterium is released from the opportunistic intestinal flora.
Doctor's consultation is required:
- for any infection in a child under one year of birth;
- if the disease is accompanied by a high (up to 39 degrees) temperature;
- the increased temperature does not drop for more than one day;
- ARI for more than two weeks;
- during the illness, a rash appeared, with acute respiratory infections - upset stool;
- normalization of body temperature alternates with its rise to high numbers (39 degrees);
- if there are concomitant allergic diseases: atopic dermatitis, bronchial asthma, neurodermatitis; recurrent urticaria;
- symptoms appear that threaten the child's life (indomitable vomiting and diarrhea, body temperature does not decrease).
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Acute intestinal infection is a disease caused by microorganisms that have entered the human intestine. The causative agents of the disease are bacteria, viruses, protozoa or fungi. The source of infection is a sick person, animal, everyday objects and the environment, food, water.
Acute intestinal infections (ACI) are characterized by indigestion, causing abdominal pain, diarrhea, vomiting, and intoxication of the body. The disease in children is severe: the body quickly dehydrates and has weak immunity.
Intestinal infections during pregnancy are dangerous: dehydration and intoxication of the woman's body lead to miscarriage or provoke oxygen starvation of the fetus.
According to ICD 10, intestinal infections are in the first place in the list, their codes are A00-A09. The most dangerous disease is cholera (ICD code 10 A00). The list of intestinal infections begins with it.
For intestinal infections, rapid spread is characteristic. Transmission - oral fecal, alimentary and airborne droplets. The infection is transmitted from person to person through unwashed hands, household items, poorly washed fruits and vegetables, and by water.
Pathogenic microorganisms are carried by insects (flies, cockroaches), sick farm animals, birds or rodents.
Pathogenic microorganisms choose the human intestine as their habitat.
Intestinal infectious diseases are similar in clinical manifestations; etiology and epidemiology are different.
Intestinal infections, a list of which can be found in the medical literature, differ depending on the type of pathogens and the effect on the body. Medical reference books, books, journals and online publications provide a list of AEIs with a description of the etiology, pathogenesis, clinical manifestations, methods of diagnosis and treatment.
Etiology of acute intestinal infections
OCI types:
Regardless of what types of microorganisms caused the disease, its symptoms are unpleasant, the treatment period is long, and the outcome is not always successful.
Epidemiology of AEI
The reasons for the emergence and spread of acute intestinal infections are that microorganisms-causative agents of diseases are quickly transmitted from a sick person or a carrier of the infection.
Pathogenic microorganisms are resistant to environmental conditions, retain harmful qualities for a long time in the cold, and remain on objects with which an infected person has come into contact.
Pathogens leave the body infected with an intestinal infection, together with feces and vomit and are transferred to the surrounding household items, water, food with the help of hands, insects, and get into water bodies with sewage. The transmission of the pathogen is "along the chain", which leads to an epidemic.
Classification of epidemics depending on the source of infection:
- Water epidemics. They are characterized by massive infection of people using the water source. When you stop using water from the source or disinfect it, the epidemic fades.
- Food epidemics. As a result of eating foods that have not undergone heat treatment, or the ingress of pathogenic microorganisms.
- Household. A large number of sick children. Infections are transmitted through toys and household items.
Epidemics vary in intensity and seasonality.
Children who are not able to follow the rules of hygiene are susceptible to intestinal diseases.
If one child is ill, the entire group of children is at risk.
Clinical picture of OCI
Intestinal infections are common diseases.
The clinic of all acute intestinal diseases is characterized by general manifestations:
The first symptoms of the disease appear 6-48 hours after infection.
Intestinal flu is the most common intestinal infection
Intestinal flu affects children from six months to two years. The nature of the disease is viral, the causative agent, rotavirus, is a pathogenic microorganism with a three-layer dense shell and a "wheel" shape.
Ways and mechanism of infection with rotavirus
Rotavirus intestinal infection is transmitted by the fecal-oral route. Trillions of bacteria leave in the feces of an infected person, while a hundred units are enough to infect others. Rotaviruses are tenacious, resistant to low temperatures and remain on those household items with which the patient or the carrier of the virus came into contact.
From these objects, they are transferred through poorly washed hands into the oral cavity of a healthy person and settle on the mucous membranes of the stomach and intestines. With close contact, rotavirus is transmitted through the saliva of an infected person.
Rotavirus is transmitted through unboiled water and food that is poorly washed or has not undergone sufficient heat treatment.
In the event of mass infection, a rotavirus epidemic occurs. The outbreak occurs in late autumn and winter. The foci of infection - in crowded places - kindergartens, schools, nursing homes, hostels.
In order to prevent the massive spread of intestinal infections in schools, preschool institutions, collectives, at enterprises, an "Operational Action Plan for the Prevention of AEI" is drawn up.
Sources of infection
Sources of infection are sick adults and children whose symptoms of the disease have already manifested themselves, or virus carriers are persons in whose body there is a virus, but there are no signs of the disease.
Rotavirus with sewage enters the water supply network, reservoirs, where bathing leads to infection.
Incubation period and duration of the disease
The incubation period lasts up to six days.
The duration of the disease with intestinal rotavirus infection is 2 weeks. The disease goes through two phases: acute and recovery phase. The first phase lasts 7 days: the body is fighting the infection, the symptoms are severe. During the second phase, the body develops immunity, and a gradual recovery begins.
Symptoms
The clinical manifestations of intestinal flu are similar to ARVI in the first days of the disease:
- temperature rise up to 39 degrees;
- headache;
- sore throat and redness,
- runny nose, cough, headache;
- pain in the abdomen;
- diarrhea;
- bouts of vomiting;
- lack of appetite;
- lethargy and weakness.
The absence of high temperature distinguishes food poisoning from intestinal infections caused by pathogenic bacteria or viruses.
A dangerous manifestation in the acute phase of the disease is dehydration. The patient must be given drink.
Features of the course of the disease in adults and children
The three-layer shell makes rotaviruses invulnerable to the environment of the gastrointestinal tract and intestinal enzymes. During the course of the disease, the virus infects enterocytes - intestinal epithelial cells - and leads to their death, modifying the epithelium. There is severe diarrhea and powerful dehydration of the body; this is the pathogenesis of the disease.
Rotavirus in children
That is due to the peculiarities of the child's body and immunity. OCI is a common disease among babies from six months to two years.
Enterovirus and rotavirus infections are common in childhood and are similar to each other. At first, parents confuse them with acute respiratory infections, as there is a jump in temperature, cough, watery eyes, runny nose. Then vomiting and diarrhea join.
With both enterovirus and rotavirus infections, the symptoms are high fever, diarrhea and vomiting, abdominal pain, lack of appetite, weakness.
Unlike rotavirus, enterovirus affects, in addition to the gastrointestinal tract, the liver, heart and nervous system of the child and affects vision.
Dehydration and intoxication are manifestations of the disease. The dehydration of the body occurs so quickly that the child does not discharge urine and tears. The pain disrupts the infant's sleep pattern.
Treatment is reduced to drinking salted water or intravenous fluids.
Breastfed babies are less prone to gastrointestinal infections due to the quality of breast milk.
Due to the high infant mortality due to intestinal infections, pediatrics pays special attention to the prevention, diagnosis and treatment of AEI in children.
To date, there are manuals and scientific articles devoted to the problems of nutrition of children, methods of their safe feeding, methods of treatment and, the development of the immune system.
Rotavirus in adults
The peculiarities of the manifestation of intestinal flu in adults is that the course of the disease occurs with less pronounced symptoms. This is due to the protection of the adult organism - the acidic environment of the stomach and the content of immunoglobulin A in the secretion produced by intestinal enterocytes.
The manifestation of the disease in an adult is an intestinal disorder. A person is a carrier of infection, unaware that an intestinal disease is hidden behind mild symptoms.
Rotavirus in pregnant women
Does not pose a danger to the fetus. Dehydration of a woman's body provokes oxygen starvation of the fetus. Therefore, it is important at the first signs of intestinal flu to prevent dehydration and stay in bed. Preventive measures and good hygiene can help reduce the risk of intestinal infection.
Diagnostics of the rotavirus infection
Identification of signs of the disease - by examining the patient and talking. Data on body temperature is recorded, blood pressure is measured, and the abdomen is palpated. Conduct studies of urine, feces and blood of the patient, examination of the mucous membranes of the rectum.
Differential diagnosis - for salmonellosis, cholera, dysentery, food toxicoinfections.
Determination of the virus based on the analysis of RSK or RTGA in the first days is impossible: antibodies are produced in an adult in a few days, in a newborn in a few months. The diagnosis is confirmed based on the epidemiological situation and seasonality.
Features of care for patients with acute intestinal infections in a hospital setting
In severe cases of illness or in the absence of the possibility of isolating the patient at home, the patient with intestinal infections is placed in a hospital.
In the process of treatment, it is important to care for patients with acute intestinal infectious diseases.
Prevention of complications of intestinal infections is an integral part of nursing care on the patient's path to recovery.
Nursing interventions provide:
- isolation of an admitted patient from a convalescent;
- control over the regular wet cleaning with bleach in the patient's room and airing the room;
- disinfection of feces;
- support of the rehydration regimen;
- control of diet and hygiene;
- control of body temperature, pressure, condition of mucous membranes and skin.
Care must be taken to care for patients with severe symptoms (fever, delirium, blurred consciousness) and for children.
Over the summer, almost any child repeatedly suffers several intestinal infections. Intestinal infection is accompanied by diarrhea and vomiting, there may be a rise in temperature, and there may be abdominal pain. Infection with microbes that cause intestinal disorders occurs as a result of the ingestion of contaminated vegetables, fruits, herbs, earth, sand, dust into the mouth. Insects (flies, ants) play a certain role in the spread of intestinal infections.
The causes of intestinal infections are microorganisms (bacteria, viruses, protozoa). Not every ingestion of these microbes leads to illness. Whether or not there is a disease depends on the amount of microbe that has entered the body, as well as on the state of defense mechanisms preceding the infection. A child with hypovitaminosis, dysbiosis, weakened by taking antibiotics is more likely to get sick than one who had no problems. Therefore, it happens that in one team someone gets seriously ill, someone easily, and someone does not get sick at all. But, if the amount of the microbe is too large, even an absolutely healthy baby will get sick. There are several particularly dangerous intestinal infections caused by certain pathogenic microbes, and with a vivid clinical picture.
Dysentery. The disease is caused by the Shigella microbe, there is also dysentery caused by protozoa - amoebas (amoebic dysentery). Infection occurs through dirty hands, water, vegetables, fruits. Dysentery is characterized by high fever (under 40 degrees), excruciating diarrhea: it may be infrequent and not abundant, but painful or with tenesmus (there is an urge, but nothing works), often in the feces - blood, abdominal pain and severe intoxication (weakness, lethargy, neurological disorders). Dysentery often requires hospitalization in the infectious diseases department.
Salmonellosis. Caused by salmonella. Infection most often occurs through food: eggs, insufficiently heat-treated meat, dairy products (there have been isolated cases of salmonellosis infection through baby food). This infection is also characterized by a high rise in temperature and intoxication, but the diarrhea is of a different nature: stools are frequent, abundant, reminiscent of swamp mud, since it is very green. Stool odor - pungent, putrid. In severe cases, hospitalization is required.
Such severe intestinal infections as cholera and typhoid fever are now extremely rare and are of the nature of epidemics (as a rule, they arise as a result of some man-made disasters, a state of emergency is declared in the lesion focus and the strictest quarantine). Therefore, these infections do not dwell in detail.
Viral intestinal infections. They are caused by different groups of viruses - the most studied of them is rotavirus, but there are others (astroviruses, parvoviruses, etc.). By the way, enteroviruses cause not so much intestinal infection as damage to internal organs and dermatitis, so they should not be counted among the causative agents of intestinal infections. Infection with viruses occurs as a result of contact with the carrier by airborne droplets, that is, through talking, coughing, sneezing. In summer, viral intestinal infections, like SARS, are less common than in the cold season. Usually, a viral intestinal infection is not accompanied by a high fever (more often it is not at all), diarrhea can be severe: frequent, liquid, but, as a rule, short-term. In most cases, such infections do not require hospitalization.
Viral hepatitis A. This disease, also known as Botkin's disease, jaundice, begins as a common intestinal infection: vomiting, diarrhea, fever, abdominal pain. Then typical signs appear: the feces become very light (white), and the urine, on the contrary, is deeply dark, yellowness of the skin and mucous membranes appears (the sclera of the eyes are especially noticeable). Requires observation of an infectious disease hepatologist, although the prognosis in most cases is favorable.
Intestinal infections of unknown etiology (CINE). In most cases, it is not possible to determine the causative agent, therefore CINE is the most common diagnosis. The term acute intestinal infection (OCI) is also used, often with a decoding: acute gastritis (vomiting and abdominal pain); acute enteritis (frequent watery diarrhea); acute colitis (feces - unformed, but not watery, tenesmus, blood, mucus). There may be a combination of symptoms: gastroenteritis, enterocolitis.
Treatment of intestinal infections, regardless of the pathogen, has common features:
· fighting dehydration. Loss of water and salt is the main danger in diarrhea and vomiting, especially in young children. With an intestinal infection, you need to drink a lot, but try to inject liquid in small portions often. In addition to the child's usual drinking for severe diarrhea (stool more than 5 times or very liquid), saline solutions (Rehydron) or 5% glucose solution should be given. If fluid loss cannot be compensated for and dehydration develops (lethargy, dry skin and mucous membranes, lack of saliva in the mouth, in children of the first months of life - a fontanel retraction, the appearance of neurological symptoms), emergency hospitalization and fluid replacement through an IV drip are required;
· fight against the causative agent of intestinal infection. Pathogenic microbes must be fought before they are identified. Therefore, in the first days of the disease, an intestinal antiseptic of a wide spectrum of action is prescribed: furazolidone (Russia) or nifuroxazide (Ersefuril (Sanofi Winthrop, France), Enterofuril (Russia)). A feature of these drugs is that they act on most pathogens of intestinal infections, including Shigella and Salmonella, but do not inhibit the normal intestinal microflora. There are other options for influencing microbes: bactisubtil (France) and its analogues; KIP (complex immunoglobulin preparation, Russia), which has an excellent antiviral effect and increases the local immunity of the gastrointestinal tract.
· maintenance and restoration of normal functioning of the gastrointestinal tract. For these purposes, enzymes are prescribed (Mezim-forte (Berlin Chemie), Creon (Solvay ), bacterial preparations: linex (LEK , Slovenia), bificol, acipol, acylact (all - Russia), primadofilus (Nature's Way, Canada).
· symptomatic therapy: stop diarrhea (Smecta (Beaufour Ipsen )), vomiting (Motilium (Janssen )), relieve spasms (No-shpa (Sanofi-Sintelabo)).
In the first-aid kit of any child who goes to the country, to the camp or with their parents at sea, these drugs should be. When a child begins to have diarrhea or vomiting, you need to start taking an antiseptic, an enzyme, a bacterial preparation in age-specific doses, lasting from 3 to 7 to 10 days. If necessary, smecta, rehydron, motilium and no-shpa are given. Timely started treatment can prevent the development of complications and quickly stop intestinal infection without harm to the body. Food for intestinal infection - frequent, fractional. Eliminate raw vegetables and fruits and raw milk, as well as sweets until stool normalization. There is no need to exclude other products. You can give a baked apple. There is no need to force food. With affordable means to fight dehydration. Hospitalization is indicated if diarrhea and vomiting cannot be stopped, medications and fluids cannot be given, signs of dehydration appear, and neurological disorders appear. Most intestinal infections do not require hospitalization, and with proper treatment and the absence of complications, the condition will return to normal within 3 days (if untreated, more than 1 week + prolonged dysfunction after infection).
Pediatrician Yuri Kopanev
Nausea, a single vomiting of about 100 ml did not bring relief.
Stool 5 times, the character of the stool is liquid, the color is transparent.
General weakness.
Medical history
Ch.U.I. She fell ill acutely. 09/11/16 in the evening, against the background of full health, I felt chills and weakness, pain in the abdomen appeared. Nausea, single vomiting, frequent loose stools (about 5 times, watery, brown, without mucus and blood), urge to defecate (took activated charcoal). The body temperature rose to 37.5 ° C. The pressure remained low. I called an ambulance and was sent to the infectious diseases department of the OGAUZ City Clinical Hospital No. 3
Epidemiological history
Lives in a comfortable apartment. Complies with hygiene rules
Contact with infectious patients denies.
The disease is associated with expired yogurt at lunch 09/11/2016. no one else drank yogurt in the family.
Immunological status: notes the transferred infectious diseases in the spring of 2016 was hospitalized 3 times for AEI. Also notes the therapy carried out in the spring about opisthorchiasis.
Therapy was performed:
Rp: Sol. Trisolum 400ml IV 2-3 times a day
Rp: Sol. Indometacini-50ml intravenously 3 times a day.
Rp: Polyphepan 5-10 g per dose 3 times a day
Rp: Acipol 1 tablet 3 times a day with food.
Rp: Panzytrat Pancitrate-10000 take 2-4 capsules with each meal.
Continuation of taking Acipol 1 tab. 3 times a day for the next 2 weeks;
The exclusion of food, alcohol, fat, milk for 2 months; the use of clean washed products should be eaten only in a well-boiled and fried form. Maintain good hygiene and avoid raw meat products.
Rules for discharging a convalescent from a hospital:
Clinical recovery
Clinical examination is not provided.
Used Books
Infectious diseases: Shuvalova E.P. / Textbook - 6th ed., Revised. And add. - M .: Medicine, 2005.
Methodological instructions for a practical lesson on the academic discipline "infectious diseases", topic: Salmonellosis, was made by the assistant of the department, Cand. honey. sciences N.N. Puchkova, Tomsk. 2011 r.
Methodical instructions for a practical lesson on the academic discipline "infectious diseases", topic: Shigellosis, amoebiasis, was compiled by the assistant of the department, V. P. Kiselev, Tomsk. 2011 r.
https://www.rmj.ru/articles/bolezni_organov_pishchevareniya/principy_lecheniya_ostryh_kishechnyh_infekciy/
Lectures on infectious diseases.
