DYSENTRY IN CHILDREN.pptx

presentation about the dysentries in children

1. DYSENTRY IN CHILDREN

2. WHAT IS DYSENTERY Dysentery refers to the presence of grossly visible blood in the stools and is the consequence of infection of the colon by either bacteria or amoeba .

3. ETIOLOGY Bacterial causes : Shigella (S. dysenteriae , S. flexneri , S. boydii , S. sonnei) E. coli ( enteroinvasive , enterohemorrhagic ) Salmonella Campylobacter jejuni Amoebic causes : Protozoa mainly Entamoeba Histolytica

4. CLINICAL PRESENTATION M/C presentation is fever and diarrhea . Diarrhea initially are watery but then shows mucus and blood . Frequency of diarrhea increases in 1-2 days . Abdominal discomfort , which later becomes more severe colicky pain. Tenesmus is present i.e. persistent spasms with ineffectual defecation, suprapubic discomfort and straining .

5. Complications Dehydration Dyselectrolytemia Hemolytic uremic syndrome Convulsions Toxic megacolon Intestinal perforation rectal prolapse Rarely , Shigella encephalopathy .

6. MANAGEMENT Investigation : If child have diarrhoea – Look at child’s general condition Is the child Lethargic / restless / irritable / unconscious . Look for sunken eyes Is the child able to drink Pinch the skin of abdomen Is there blood in stool ? If yes, start treatment for dysentery Stool culture and sensitivity for causative organism

7. Treatment Components of Treatment Administration of ORS Continuation of oral diet (fluid rich diet ) Zinc supplementation Antibiotics

8. Bacterial dysentery : Ciprofloxacin (15mg / kg / day ) in two divided doses for 3 days . Intravenous ceftriaxone ( 50 – 100 mg /kg/ day) for 3-5 days first line of treatment in a sick child In a stable child , oral formulation are given . Patient is monitored for 48 hours for clinical improvement. If no improvements are seen antibiotics must be changed like oral azithromycin .

9. Amoebic Dysentery Tinidazole or metronidazole is used . Health Education Personnel hygiene Environmental hygiene Good Sanitation / Purification of water supply Food Handling care