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 .

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

7. 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

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

9. • 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 .

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