For the first lesson you have to learn 3 topics: "Polio. Enterovirus infection“ "Viral hepatitis A, B, C" " Infectious diseases of elementary tract (shigellosis, salmonellosis) ". To prepare for classes necessary for e-book in the library: Yu. P. Kharchenko, A. M. Mikhailova, S. O. Kramarev, I. V. Yurchenko, G. A. Shapovalova, A. I. Savchuk INFECTIOUS DISEASES in CHILDREN. - Odessa: 2008. the website of the department: http://pedpo.med.sumdu.edu.ua

Acute intestinal infection in children: clinical manifestations Sumy State University Lecturer Bynda Tatyana P.

AIDs (acute intestinal diseases) AIDs take one of the leading places in infectious pathology of childhood, being responsible for more than 50% of all the registered diseases in children. According to WHO (World Health Organization), more than 1 milliard diarrheas are registered every year in the world, children under 5  accounting for 60-70% of them; about 3 million preschool children die.

Acute intestinal diseases AIDs are acute infectious diseases caused by specific agents (bacteria, protozoa, and viruses) and characterized by invasive, secretory and osmotic mechanisms of impairment of gastrointestinal tract. It is manifested by local inflammatory process and general intoxication with dysfunction of central and vegetative nervous system, microcirculation and metabolism.

Epidemiology The source of infection are patients with AIDs and bacillicarriers

Epidemiology Mechanism of transmission is fecal-oral. The factors of transmission are hands, foodstuffs, water and flies. According to the factor of transmission, there are different ways of contagion: by direct contact, through food and water.

General clinical manifestations of AIDs The main clinical syndromes characteristic of AIDs are syndromes of involvement of gastrointestinal tract, toxicosis.

The main syndromes of involvement of gastrointestinal tract Gastritis as an isolated impairment of GIS occurs more often in older children There is Pain and constant heavy feeling in the epigastric region; Nausea and vomiting; The tongue is coated.

The main syndromes of involvement of gastrointestinal tract 2. Enteritis is usually manifested by swelling of the stomach, flatulence (“rumbling in the stomach”), pain in the paraumbilical region. The stool is plentiful, watery, often foamy, with strong smell. There is a marked venous net on the skin of the abdomen. The syndrome of enteritis is often combined with some form of gastritis.

May be intertrigo, irritation in skin folds

3. Colitis syndrome. As a rule, the stomach is sunken, but may be swollen in children under 1 year. The pain is usually spasmodic, localized in the lower part of the abdomen, more often in the left iliac region.

false impulses to defecate (tenesmus), 3. Colitis syndrome. There are false impulses to defecate (tenesmus), feeling of incomplete evacuation of feces from the intestine after defecation.

On palpation, the sigmoid colon is spasmodic and tender. 3. Colitis syndrome. On palpation, the sigmoid colon is spasmodic and tender. The anal sphincter is weak; The stool is scanty and frequent, with considerable mucous admixtures and traces of blood.

General clinical manifestations of acute intestinal infections The signs of distal colitis are the following: the stool is very frequent, scanty with great volume of mucus (“rectal spit”); gaping of the anus; tenesmus; prolapse of the rectum. In infants, colitis syndrome is manifested by uneasiness, making efforts to defecate, moving of legs, and reddened face at defecation.

CRITERIA OF SEVERITY IN ACUTE INTESTINAL INFECTIONS

SLIGHT MODERATE SEVERE slight intoxication general condition slightly changed, temperature up to 37,0-38,5°С, moderate intoxication (limpness, reduced appetite), temperature up to 38,5-39,5°С, severe intoxication, anxiety, convul-sions, meningeal symptoms body temperature up to 39,5-40°С, rare vomiting (0-1 time) repeated vomiting (1-2 times) vomiting 3 times and more, dehydration (2-3 degree) stool 5-7 times a day stool up to 10-12-15 times a day, stool more then 12-15 times a day

What should be your diagnosis? The primary diagnosis: AIDs, enteritis, moderate severity.

Diagnosis and laboratory studies Epidemiological history taking Clinical manifestations (general intoxication syndrome + diarrhea syndrome) Laboratory studies: а) coprogram (micro- and macroscopic study of feces) b) bacteriological studies (feces, blood, urine, vomiting masses, stomach discharge after irrigation for differential diagnostic media) c) serological tests (direct hemagglutination reaction and indirect hemagglutination reaction; Vidal’s reaction), immunoenzyme method; d) express methods (IFR: immunofluorescence reaction