Complications of bacillary dysentery in children

Bacterial dysentery is relatively common in children. If a child has unclean diet, or eats some spoiled food, or has some cross infection, it may cause dysentery. If the condition is more serious, it may even lead to some complications, often causing intestinal ulcers and even bloody stools. More serious cases may even cause intestinal perforation, which is quite harmful to children.

Complications of bacillary dysentery in children

Children with acute bacillary dysentery may suffer from severe vomiting and diarrhea, and may also suffer from water and electrolyte imbalance (dehydration, acidosis, hypokalemia, hyponatremia, hypocalcemia, etc.). Chronic bacillary dysentery is prone to complications, which are mainly caused by malnutrition and low immune function. The most common ones are malnutrition and malnutrition edema, deficiencies of multiple vitamins and trace elements, manifested as dry eye disease, nutritional anemia, rickets, and in severe cases, beriberi and scurvy may occur. The latter is rarely seen in our country. Deep intestinal ulcers can cause massive intestinal bleeding, frequent diarrhea can cause rectal prolapse, and prolonged use of antibiotics can cause intestinal flora disorders or combined fungal infections. In some severely malnourished children, intestinal ulcers cannot be repaired for a long time and intestinal perforation may occur.

When common bacillary dysentery is seen with bloody stools, the following points should be noted to help confirm the diagnosis:

1. Diarrhea in summer and autumn is accompanied by fever and stool with mucus, pus and blood.

2. If there is a recent contact history of dysentery in the home or roommate, you should be alert.

3. Beijing standard for stool microscopy: if there are >15 pus cells and red blood cells in each high-power microscopic field, bacillary dysentery can be diagnosed in the outpatient clinic and the infectious disease card can be filled out.

4. Stool culture Strictly speaking, accurate diagnosis depends on stool culture. When culturing, take fresh bloody and purulent stools. It is best to inoculate and culture at the bedside. If it cannot be done immediately, the specimen can be stored in buffered glycerol saline and sent to the bacteriology laboratory for culture as soon as possible. Collecting stool specimens before antimicrobial treatment can increase the culture positivity rate.

5. PCR rapid diagnosis PCR rapid diagnosis method has been developed recently, but it requires multiple specimens to be examined together and cannot be widely used in clinical practice.

1. The incubation period ranges from a few hours to 8 days, with most cases lasting 1 to 3 days.

2. The clinical classification of bacillary dysentery can be divided into acute bacillary dysentery, chronic bacillary dysentery and toxic dysentery according to the course and condition of the disease. Because the special conditions of toxic dysentery will be described later, we will first discuss the general course of acute bacillary dysentery and chronic bacillary dysentery.