A common bacterial infection is dysentery in children: symptoms and treatment with medications and a special diet. Dysentery in children, causes, symptoms, treatment, signs

Dysentery is a common bacterial intestinal infection that is diagnosed in children. This disease is most common among preschool children. This can be attributed to the fact that older children practice better hygiene and do not put toys and fingers in their mouths. Of all those sick with dysentery, the main percentage are preschool children. In order not to confuse this dangerous disease with a simple digestive disorder, parents need to know the main symptoms of dysentery in children under one year of age and older. This will help you quickly make a diagnosis and begin proper treatment.

Routes of infection

The disease is caused by bacteria of the genus Shigella. These pathogenic microorganisms reproduce well in any environment - water, soil, food products, and tolerate low temperatures well. These bacteria are sensitive to heat, disinfectants and direct sunlight. When boiled, Shigella dies within a couple of seconds. The source of infection is a sick child, who is contagious from the first day of illness, since many pathogens are released with feces. The infection is transmitted in the following ways:

Fecal-oral. By water - when swimming in open reservoirs and pools, as well as when consuming raw water. By food means by eating poorly washed vegetables or fruits;
Contact-household - transmitted through kitchen utensils, bed linen, various toys and household items.

A large number of cases of dysentery are recorded in the summer-autumn period when eating a lot of fruits, berries and vegetables. In addition, the warm period promotes the growth of bacteria on food products.

Causes of dysentery

Dysentery is caused by four types of Shigella, which were named after the scientists who first discovered them:

Sonne.
Flexner.
Grigorieva-Shiga.
Boyd.

The causative agents of dysentery differ in different regions. In European countries, dysentery is caused by Sonne's bacillus; Flexner's dysentery is diagnosed a little less frequently in children. In the countries of Central Asia and the Far East, the disease is caused by the Grigoriev-Shiga bacillus and is quite severe.

Most often, infection occurs if raw water, unboiled milk and other products without heat treatment are consumed. The danger of infection also arises when consuming poorly washed vegetables, fruits and berries. The disease is often diagnosed during the ripening period of strawberries, raspberries and grapes, and some adults do not wash melons before offering them to their baby.

If a patient with shigella does not wash his hands after visiting the bathroom, then he transfers the pathogen on his hands to all objects he touched. Dysentery in children occurs if a child takes an infected household item and then puts his hands in his mouth.

Children are very susceptible to dysentery, regardless of age. But most cases are diagnosed before the age of 3 years. Provoking factors can be artificial feeding of a newborn, hypovitaminosis, diseases of the digestive organs and unsanitary conditions in housing.

General characteristics of the disease

Only Shigella Grigoriev-Shig produces toxins into the bloodstream during life; other pathogens release toxic substances upon death. Immunity does not remain after suffering from dysentery; you can get sick again during your life more than once.

With dysentery, the whole body suffers, but the lower part of the large intestine is most vulnerable, where the sigmoid colon is affected. A small volume of the pathogen, when it enters the digestive tract, dies and at the same time releases toxic substances. They are absorbed into the blood and, acting on the walls of blood vessels, increase their permeability. This causes pathological conditions in the intestines. Shigella multiplies in the intestinal mucosa and in some lymph nodes.

Inflammatory processes in the intestines are classified depending on the degree of damage:

Mild course of the disease - redness and swelling of the mucous membrane occurs, minor hemorrhages are noticeable.
Severe course of the disease - superficial necrosis of the mucous membrane occurs, ulcers appear in some places of the intestine after necrotic cells are rejected.
A very severe course of the disease - ulcers appear in the intestinal walls, then scars appear in these places. Other pathogenic microorganisms, such as fungi, streptococci and staphylococci, can also provoke such ulcers.

Damage to the intestinal walls leads to disruption of the organ. This is manifested by increased peristalsis, increased frequency of stools, the appearance of mucus and bloody spots in the stool, and pain in the affected parts of the intestine. Toxins released by the dysentery bacillus affect blood vessels and nerve cells not only in the intestines, but also in the central nervous system.

Thanks to the infection, the work of all other digestive organs is disrupted, therefore all metabolic processes in the body are disrupted. Toxic substances and under-oxidized products cause disruptions in the functioning of the cardiovascular system and pathological changes in various organs.

Therefore, if dysentery is diagnosed in a child or adult, then you should not take this disease lightly. Quite serious complications can arise that will require more than one month of treatment.

Severe intoxication of the body can cause death in weakened children. Dysentery in infants is especially dangerous; with low body weight, dehydration quickly occurs, which leads to irreversible consequences.

Symptoms of dysentery

Signs of dysentery in a child are usually more pronounced than in adults, and the disease itself is much more severe. The incubation period can range from three hours to a week - it depends on the amount of pathogen that has entered the body. Shigellosis can occur usually or atypically, have a smooth course or cause severe complications. The duration of the disease also varies. In the acute form it lasts up to two months, in the protracted form up to three months, and more than three months in the chronic form.

Dysentery can be mild, moderate, severe and toxic. The disease, which was provoked by the Sonne bacillus, often proceeds easily, without severe damage to the intestinal mucosa. There is an erased course of the disease. Flexner's dysentery in children causes severe damage to the intestinal walls, so the disease is quite severe.

The onset of dysentery is usually very acute, the symptoms are quite specific:

Body temperature reaches critical levels and lasts for about three days. This is accompanied by a headache.
There is no appetite, nausea develops, and repeated vomiting is possible.
The child becomes lethargic and has atypical drowsiness.
The child complains of severe pain in the left side, which decreases immediately after defecation.
The abdomen is painful on palpation along the intestine.

The baby defecates very often, from 5 to 30 times a day. From the very beginning of the disease, the bowel movements are copious and liquid, but the next day they become scanty. You can see greenery, mucus and streaks of blood in them. In severe cases of the disease, there is no feces, only greenish mucus comes out in a small volume. Dysentery is characterized by a false urge to go to the toilet.

Constant tension in babies can lead to a gaping anus, most often noticeable in children who are 2 years old or younger. In rare cases, straining may cause rectal prolapse, which will require the help of a specialist.

The severity of dysentery depends on the intoxication of the body and the degree of intestinal damage.

Light form

The child's condition remains almost unchanged. Defecation becomes more frequent up to 8 times a day, but stools are not very rare and contain some mucus. With this course, the condition improves within a few days; fever rarely occurs.

Moderate form

Intoxication manifests itself with mild symptoms. Body temperature rises during the first days to 39, then stabilizes. Vomiting occurs, the child complains of severe pain in the abdominal area. Defecation occurs more than 10 times per day; there is mucus and blood in the stool. The condition returns to normal after a week, but even in formed stool, mucus may be present for a long time.

Severe form

Symptoms manifest themselves more in the intestines, although intoxication is also present. Stool with abnormal impurities, the child goes to the toilet more than 15 times a day. A high temperature is observed, which, with proper therapy, decreases to 37.5 and persists for a long time, as does weakness with poor appetite. The intestinal mucosa takes a very long time to recover, and the diarrhea stops after a week.

Toxic form

It manifests itself as severe intoxication of the entire body. Repeated vomiting, general weakness and fever occur. Most often, this form of the disease is diagnosed as a food infection because there is no diarrhea. Loose stools appear a couple of hours after the first symptoms and quickly turn into scanty stools, with mucus and blood streaks. The baby's tummy sinks a little; you can feel the tense rectum.

Hypertoxic form

This form is characterized by disturbances in the functioning of the cardiovascular system.. There may be convulsions and fainting.

The skin becomes bluish, the extremities become colder and blood pressure drops.

The duration of the disease depends on the age of the baby and the time of treatment. Therefore, it is very important to quickly show the child to an infectious disease specialist.

With this form of dysentery, death often occurs even before the appearance of loose stools.

Chronic form

Any form of dysentery in children can become chronic. Other diseases can provoke this unpleasant process - rickets, anemia or helminthic infestation. Repeated infection with Shigella can lead to a chronic form of the disease. This form occurs with mild intoxication of the body - the child is weakened, has poor appetite, pain in the lower abdomen and rare stools. But the body temperature is normal. Other digestive organs are often involved in the disease, so metabolism is disrupted.

Features of the course of the disease in infants

In babies under 1 year of age, the infectious disease has a number of features:

Symptoms appear gradually. The stools are rare, very fetid and mixed with mucus.
The stomach does not retract, but swells.
The baby is restless and cries a lot when defecating.
A secondary infection often develops - pneumonia or otitis media.

Uncontrollable vomiting and diarrhea quickly lead to dehydration of the baby's body. The absorption of proteins is disrupted, flatulence and heart failure occur. Convulsions and fainting are possible. In especially severe cases, kidney and liver failure occurs.

Treatment of shigellosis

Treatment is carried out at home or in a medical facility, it depends on the patient’s age and form of the disease, as well as some factors. Treatment of dysentery in children at home is allowed only if the disease is mild., and if there are no other children in the family who may become infected. Also, there should be no people in the house who work in the food industry or child care institutions. Complex treatment is carried out, which consists of the following measures:

compliance with the regime;
treatment with medications - antibiotics and others, depending on the symptoms;
dietary food.

In the acute phase of the disease, bed rest is indicated for a child of any age.

Treatment with antibiotics is indicated for severe disease. Antibiotics of different groups are used, to which Shigella is sensitive - gentamicin, ampicillin. But most often they use nitrofurans, which are antimicrobial drugs.

If a child is severely dehydrated, he is carefully hydrated. For this purpose use plain water, teas, decoctions of dried fruits, compotes and jelly. Rice water, which is often given in small portions, helps a lot. In a hospital setting, intravenous administration of solutions - glucose and saline - is indicated.

For severe pain in the abdominal area, antispasmodics are prescribed. If there are signs of enzyme deficiency, Mezim, Festal or Creon are prescribed. To quickly restore digestion, probiotics and vitamin complexes are prescribed.

How long a child needs to stay in the hospital for dysentery is decided only by the attending physician. But therapy is continued until all symptoms disappear and test results are good.

Diet during rehabilitation

A diet for dysentery in children is prescribed immediately after the acute symptoms subside. Therapeutic fasting in children is not currently practiced; food is given in small portions. If the baby is on artificial feeding, then he is temporarily transferred to fermented milk products.

For children over one year old, a messy porridge is cooked from oatmeal, buckwheat and rice. You can give pureed vegetable soups, as well as steamed meat products. Applesauce, which contains pectin, normalizes digestion well.

After a child has had dysentery, he should not eat fried or smoked foods for about two months. And also spicy food, which is flavored with a lot of spices.

How to prevent shigellosis

Preventive measures to prevent cases of the disease are simple and boil down to compliance with hygiene rules:

Hands must be washed after going outside and going to the toilet..
Vegetables, fruits and berries are thoroughly washed with running water and then rinsed with boiling water.
You should not eat foods of questionable quality.
If a case of dysentery is registered in a children's group, then quarantine is introduced.
The dishes for feeding a bottle-fed baby are washed well and doused with boiling water.

It is easier to prevent any infectious disease than to treat it later. Therefore, parents should instill hygiene skills in their children from early childhood. If the child does get sick, then you should not self-medicate, you need to consult a doctor for advice and treatment.

Children are highly susceptible to various diseases. Dysentery is one of the most common diseases among young patients. This intestinal infectious disease is also called the disease of dirty hands, since the main cause of its occurrence is non-compliance with the rules of personal hygiene. Children make up more than 70% of the total number of patients with this disease. These are mainly preschoolers (from 2 to 7 years old), who often put various objects or their own hands into their mouths.

How is dysentery transmitted: routes of transmission, causes

The main cause of acute intestinal disease are various types of pathogens of the genus of gram-negative rod-shaped bacteria - shiggel. To establish the exact cause of the disease and identify the source of infection, it is necessary to know the mechanism of infection.

In children, infection occurs in the following ways:

water;
food;
contact and household.

The most common source of infection for children is food that has not been heat-treated (dairy products, salads, etc.) or is poorly washed, has expired, or is stored incorrectly.

Water can also be a source of infection. Infection mainly occurs through consumption of raw (that is, unboiled) liquid, especially from unreliable sources. For example, well or spring drinking water is often contaminated by feces that migrate from the soil into the groundwater.

In case of contact-household infection, the child is infected through household items (dishes, door handles, linen, etc.) or toys. If the carrier of the infection does not wash his hands after defecation, then he transfers the infection to all objects he touches, and the child, in turn, coming into contact with the same things, introduces the “infection” into his body. That is why it is so important for those surrounding the baby to carefully observe all the rules of personal hygiene. Indeed, in most cases, children become infected from people who care for them.

How to determine that a child has dysentery: symptoms

The clinical manifestation of acute intestinal disease depends on many factors: the type of bacterium, the degree of infection, the patient’s age, the state of his immune system, and the presence of concomitant pathological processes.

At the initial stage of development, the disease is manifested by general malaise, weakness, increased temperature, nausea and vomiting. Later, the main symptoms are complicated by intestinal disorders. In some children, the infectious disease immediately begins with intestinal dysfunction, which is manifested by painful sensations in the abdomen and diarrhea, while children's feces retain their fecal character, but over time, mucous and bloody streaks appear in them. Soon the feces become greenish in color, and the frequency of urges can reach up to 20 times a day.

Features of the course of dysentery in young children

It is much more difficult to determine signs of bacterial infection in children of the first year of life. Firstly, they cannot yet independently tell their parents about their health problems. Secondly, the clinical manifestation of an infectious disease has a slightly different character:

gradual development of colic syndrome;
disruption of the normal functioning of the gastrointestinal tract;
the fecal character of the stool remains;
green color of stool with mucus and lumps of undigested food, in rare cases, bloody streaks may appear;
foul-smelling stool;
bloating;
pain during defecation.

In severe cases, one-year-old children may experience frequent vomiting, severe diarrhea, fever, and significant weight loss.

What to do if your child has dysentery

It is impossible to cure dysentery on your own without medical help. Therefore, the first thing parents should do when they discover signs of infection is to show the child to a doctor and undergo the necessary examination. Treatment of an infectious disease is carried out on an outpatient or inpatient basis. This largely depends on the severity and clinical form of the disease.

Treatment of dysentery in children is carried out comprehensively. Treatment includes taking medications, following a certain regimen, and dietary nutrition.

Antibiotics

Antibiotic therapy is prescribed for moderate and severe forms of infection. The type of drug depends on the type of pathogenic microorganisms, in our case bacteria of the genus Shigella. The most commonly used drugs are Ampicillin, Gentamicin, Polymyxin, Furazolidone, Nifuroxazide, etc.

However, do not forget that treating your baby with antibiotics yourself is prohibited and dangerous. The duration of therapy and dosage should be determined exclusively by a specialist.

Treatment at home with folk remedies

Doctors approve of the use of traditional medicine in the treatment of dysentery in children. However, parents should keep in mind that Mother Nature's medicines only bring results if the therapy is carried out comprehensively, so be sure to discuss this issue with your doctor before using them.

In case of infection, it is very important to give your child as much to drink as possible. And in this case, traditional therapy recipes come to the rescue. Young patients are recommended to be given various decoctions, for example, rice, chamomile, apple. Rice porridge cooked in water without adding salt is also useful in the treatment of dysentery.

Diet

Nutrition during the treatment period is selected based on the patient’s age. Typically the diet menu includes the following dishes:

porridge (semolina, oatmeal, rice);
steam products (cutlets);
vegetable soups;
grated apple;
jelly, decoctions.

As a rule, the patient begins to feed after the vomiting stops. The first days the child should eat often and in small portions. If the baby is bottle-fed, then give preference to fermented milk mixtures.

From the second week of treatment, if the doctor allows, the little patient’s nutritional diet can be gradually expanded. However, it is necessary to abstain from spicy, salty, fried and fatty foods for about 2-3 months after recovery.

Where and how to treat the baby is decided solely by the doctor. The main task of dad and mom is to strictly follow all medical recommendations. Home treatment involves following all measures to prevent infection of others and caring for a sick child. The following recommendations will help speed up the recovery process and prevent infection of others:

take care to eliminate the source of infection and disinfect the house;
observe bed and sanitary conditions;
control the intake of medications prescribed by your doctor;
Provide your child with a balanced, balanced diet.

Urgent Care

If a patient develops symptoms of an acute intestinal disease (diarrhea with blood, high fever), action must be taken immediately. What you can do:

contact a doctor and call an ambulance;
give the child to drink as much as possible, the best drink in this situation would be boiled water with added sugar (2 tbsp) and salt (1 tbsp);
do not give the baby any medications without the doctor’s permission - this can complicate the course of the disease and harm the little patient;
isolate a sick child from household members and ensure that his feces are immediately flushed down the toilet.

Consequences and complications

With illiterate treatment and the complex course of an infectious disease in children, chronic pathologies can worsen, concomitant diseases may arise and the development of dysentery itself may be complicated. If the intestines are deeply damaged, the child may experience the following complications:

bleeding in the gastrointestinal tract;
cicatricial strictures;
intestinal perforation with subsequent inflammation;
rectal prolapse;
the occurrence of dysbacteriosis.

In addition, complications may arise, the mechanism of development of which in shigellosis has not yet been studied, namely:

joint damage (arthritis);
inflammation of peripheral nerves (neuritis);
inflammatory process in the iris of the eyeball (iritis);
brain damage (encephalitis).

Especially for - Marina Amiran

The children's body is especially susceptible to pathogens of intestinal infections. Most parents try to instill hygiene skills in them from the first months of life. However, it is not always possible to monitor whether a child has washed his hands, especially if he is visiting or communicating with other children. Once in the baby’s body, the infection takes root in the intestines, which leads to the development of complications. One of the dangerous intestinal diseases is dysentery, which sometimes becomes chronic in children. You need to know what symptoms you should see a doctor for.

Content:

Features of the disease

Dysentery is an intestinal disease in which infection affects the large intestine (sigmoid colon). Substances released by microbes corrode the mucous membrane and poison the entire body. A child's illness may be isolated, but seasonal infectious outbreaks often occur (especially in children's institutions).

There are many factors that contribute to the development of intestinal infections in children. An older child, as a rule, already understands what bacteria are, why they are dangerous, and why they need to wash their hands often. A small child does not yet have such skills. Children of preschool age are most often affected. In infants, the disease is observed very rarely, mainly if they are fed formula milk or the body is weakened due to the presence of diathesis, anemia, or rickets.

Types of dysentery pathogens, routes of infection

Dysentery is caused by Enterobacteriaceae called Shigella. There are several types of these bacteria. Some of them are less aggressive (Shigella Sonne), the disease caused by them occurs in a milder form. Others (Shigella Flexnera) are causative agents of extremely severe forms of the disease.

Shigella can be found in water, food, and soil. They withstand environmental conditions well: they can be stored in frozen foods for 1 month and do not die when dried. They can be found on dishes, clothes, and various household items.

The most common cause of a child contracting dysentery is contact with a sick person. Bacteria are on his hands if he does not wash them after using the toilet, on clothes or towels that he has touched. Some people may be bacteria carriers, although they themselves do not get sick.

Note: The famous children's doctor E. Komarovsky emphasizes that the spread of dysentery is often people who do not take the symptoms of the disease that appear in them seriously. Having stopped diarrhea with the help of tablets, they remain carriers of bacteria, infecting those around them, primarily children.

Dysentery bacilli are excreted from the body in feces. Infection occurs through the fecal-oral or contact-household route. In this case, the source of infection can be poorly washed vegetables picked up from the ground, as well as water from natural bodies of water that gets into the mouth while swimming, or products that have not undergone sufficient heat treatment.

The causative agents of dysentery cannot withstand boiling and die already at a temperature of 60° after heating for half an hour. Direct sunlight and disinfectants have a detrimental effect on them.

Dysentery most often occurs in the warm season, when conditions for the growth of bacteria are most favorable. Warm food spoils faster. In summer, people eat more greens, vegetables and fruits, but they do not always wash them well.

Stable immunity to this disease is not developed, so the danger of re-infection always exists. Dysentery can occur in mild, moderate, severe and toxic forms. The disease can become chronic.

Addition: There is another intestinal disease with similar symptoms, in which intestinal damage is caused by amoebas - protozoan microorganisms. Due to the similarity of symptoms, this disease is called amoebic dysentery. However, there are distinctive features of its course and treatment. Amoebas penetrate into the wall muscle, forming ulcers. A disease of this type is considered endemic (characteristic of an area with certain natural conditions). It usually occurs in people living in hot climates.

Video: The action of dysentery pathogens in the body. Cause and signs of the disease

Causes of dysentery

Dysentery in children can occur for the following reasons:

living in unsanitary conditions, the presence of flies in the room - carriers of infection;
failure to comply with personal hygiene rules;
eating stale, poorly processed or improperly prepared foods, as well as bad water;
close contact with other children or adults in children's groups, where there may be sick people or carriers of bacteria;
swimming in natural bodies of water, as well as getting sand or soil from objects that the child uses outside into his mouth.

Factors contributing to the development of bacteria in the body are weak immunity, as well as the presence of digestive diseases in the child.

Signs of dysentery of varying severity

Toxins released by dysentery bacteria in the intestines cause inflammatory processes in the intestinal mucosa. Absorbed through the walls of blood vessels, they spread to other organs, which leads to various complications of the disease.

On average, the incubation period lasts from 2 to 7 days. The severity of symptoms depends on the form in which dysentery occurs, as well as on the age of the baby. Manifestations of the disease can be obvious (typical) or hidden (atypical).

Improvement in children's condition occurs after 7-10 days if the disease is acute and treatment is started immediately. In severe cases, the disease can last 2-3 months. And sometimes it doesn’t go away for a longer time. Then they talk about the appearance of chronic dysentery in children.

Light form

Leads to the formation of small areas of hemorrhage occurring due to corrosion of the blood vessels of the mucosa. The child experiences a slight increase in body temperature. He defecates more often than usual (up to 8 times per day), while a little mucus appears in the liquid feces, and there are no blood impurities.

Moderate illness

The child experiences inflammation of the mucous membrane, swelling occurs, and ulceration begins. For 3 days the temperature reaches 39°C, bowel movements become more frequent up to 10-15 times a day, nagging cramping pain appears in the lower abdomen, and vomiting occurs. The baby feels unwell for about a week; after appropriate treatment, the symptoms disappear.

Severe form

Necrosis of certain areas of the intestinal lining occurs. Ulcers appear at the site where dead cells are discharged. The deeper layers of the intestinal wall are affected, and other pathogens (staphylococci, streptococci, fungi) also enter them. The muscles of the intestinal wall contract spasmodically. Symptoms of intoxication are less noticeable.

The temperature does not exceed 37.5° and lasts for a long time. Blood and a large amount of mucus appear in the stool. The frequency of bowel movements is more than 15 times a day. The child experiences rumbling in the stomach and weakness. Due to the fact that frequent false urges occur, the baby strains strongly, and there is swelling in the anal area (the so-called “anal gape”). Even minor bowel prolapse may occur.

However, timely and adequate treatment after a week leads to relief of his condition. The child must be kept on a diet for a long time.

Toxic form

With this form of the disease, dysentery in children occurs with a predominance of signs of toxicosis, such as frequent vomiting, high fever, and headache. Doctors may not even suspect dysentery at first, since frequent urges to defecate, changes in stool and abdominal pain appear only a few hours after the first manifestations of ill health. Abundant, loose stools gradually become scanty, but very frequent, containing mucus and blood. Due to cramps in the abdomen, severe pain is felt, and he looks sunken.

Hypertoxic

This is an extremely severe form of dysentery. The child experiences convulsions and may lose consciousness. The work of the heart is disrupted, the heartbeat slows down, and blood pressure drops. The skin turns pale. The limbs turn blue and become cold. There is a high probability of death, especially in very young children.

Features of chronic dysentery

The causes of symptoms in any form of the disease are:

dehydration of the body, disturbance of water-salt balance;
damage to the mucous membrane and intestinal wall;
intoxication leading to disruption of other organs and serious consequences.

Chronic manifestations can be the result of a protracted course of the disease, but they also occur with repeated infection with the dysentery bacillus.

The child has a normal temperature. But often causeless diarrhea and spasmodic pain below the navel occur. There is mucus in the stool, sometimes blood appears. The baby has a poor appetite and gets tired quickly. Digestive disorders lead to the development of vitamin deficiency and anemia.

Such symptoms can be observed constantly (continuous course), or may occur periodically (recurrent course).

How does dysentery occur in infants?

In young children, dysentery is more likely to manifest symptoms of dehydration (due to vomiting and diarrhea), as well as the effects of toxins on the cardiovascular system. In addition, there is a high probability of secondary complications, such as otitis media and pneumonia. Often the disease becomes chronic with a temporary improvement in the baby’s condition and periodic resumption of symptoms.

Unlike older children, infants experience not retraction, but bloating of the abdomen. Emptying the bowels is painful for him, in addition, there is irritation of the anal area, so he cries during bowel movements. There is liquid green stool with a strong unpleasant odor and an admixture of mucus.

Sometimes dysentery is combined with salmonellosis and other bacterial diseases. In this case, the temperature rises to 39°-40°. The child quickly loses weight, becomes weaker, and may experience convulsions. If emergency treatment is not started, heart and kidney failure occurs.

When to call a doctor urgently

Since dysentery is a dangerous disease that usually develops very quickly in children, and the consequences can be very severe, you should not hesitate to consult a doctor. Moreover, it is unacceptable to self-medicate, try to stop diarrhea in any way, wasting precious time, complicating the course of the disease.

A doctor should be called to your home, as the patient is contagious. This is done when symptoms such as fever, weakness, flatulence (the presence of a stench in the escaping gases), headache, chills, abdominal cramps, loose stools (and they may not appear immediately) appear. The baby's urge to defecate becomes more frequent, but attempts are ineffective.

A sure sign of the disease is bloody mucous diarrhea.

Complications and consequences of dysentery

Due to damage to the intestinal wall and the formation of ulcers, tissue scarring occurs, which leads to a narrowing of the rectal lumen until obstruction occurs. Vascular damage causes life-threatening internal bleeding. Ulceration of the intestinal wall promotes the penetration of bacteria into the abdominal cavity and the development of peritonitis.

The appearance of secondary diseases associated with the spread of infection to other organs is possible (iritis - inflammation of the iris, encephalitis - inflammation of the brain, arthritis - joint disease, and neuritis - damage to nerve endings). Often, in young children, pneumonia occurs as a result of the penetration of the dysentery bacillus into the lungs.

Diagnostics

The diagnosis is made based on the results of laboratory tests of stool and vomit. Common examination methods are:

Coprogram (examination of stool under a microscope to detect blood, protein, fats, and particles of muscle tissue). This method allows you to assess the degree of damage to the mucosa and destruction of the intestinal wall.
Bacteriological culture of feces and vomit. It is performed to clarify the type of bacteria and select an antibacterial agent.
Immunological tests (ELISA, for example) to detect antibodies to the dysentery bacillus.
PCR analysis (determining the type of pathogen by its DNA).
Sigmoidoscopy - examination of the rectum using an endoscope to determine the severity of damage to the walls.

Using these methods, you can make sure that the child has dysentery and not salmonellosis, viral diarrhea, ulcerative colitis or another intestinal disease.

Treatment

First of all, when dysentery is detected in children, antibiotics (ampicillin, gentamicin, furazolidone) are prescribed. In addition, medications are prescribed to restore salt balance and eliminate the effects of dehydration. Ringer's solution with glucose and mineral components is administered intravenously. Drugs such as rehydron, oralit, glucosolan are prescribed for oral administration in the form of aqueous solutions.

To relieve abdominal pain, children are given papaverine or no-shpu, and to support the functioning of the pancreas - pancreatin, festal. Agents that restore intestinal microflora (bifidumbacterin, lactofiltrum), sorbents (espumisan or enterosgel for intestinal bloating), as well as a variety of vitamins are also prescribed.

The baby needs to follow a diet. It should be fed in small portions. You can give rice porridge, tea with crackers, mashed potatoes and pumpkin, baked apple, steamed cutlets. Whole milk, raw vegetables, black bread, legumes, and cabbage are excluded from the diet.

It is recommended to feed bottle-fed babies with yogurt diluted with rice water.

Video: Dr. E. Komarovsky on the manifestations and prevention of intestinal infections in children

Prevention of dysentery

To prevent dysentery from occurring in children, parents need to follow some rules. First of all, create normal sanitary living conditions for the child and teach him to wash his hands frequently.

Children's food must be freshly prepared. It must be stored in the refrigerator. You should not give your child expired food or buy food from street kiosks. Milk purchased at the market must be boiled. You can only give your child water that is boiled or bottled.

A small child should not be allowed to swim in a pond or river, where he could accidentally ingest contaminated water. The child needs to be explained from an early age why it is necessary to wash their hands after using the toilet and before eating. Fruits and vegetables intended for feeding a child must not only be washed, but doused with boiling water. This will lead to rapid death of bacteria.

Newborn babies rarely suffer from this disease. But there are some reasons why babies may have dysentery in the first month of life.

Premature and low birth weight babies are most often infected. They may develop dysentery with concomitant acute respiratory viral infection. Babies suffering from rickets, diathesis and anemia are also at risk of becoming infected with Shegella bacteria. There is a possibility of infection with dangerous bacteria during childbirth if the mother is sick with dysentery. With artificial feeding, the risk of infection increases. The source of infection for newborn children is usually the mother and other people around who care for the child. Infection with bacteria can occur through toys, clothing, and bedding. The infection can enter the newborn body through running water if the baby drinks it. Flies are carriers of acute intestinal disease. They can land on baby dishes, toys, clothing, or the newborn baby itself.

Symptoms

The disease in an infant can be determined by the signs that appear.

Dysentery in a newborn begins abruptly. Babies' stool becomes liquid with an admixture of cloudy mucus and greens. Blood may appear in the stool, but usually it occurs 3-4 days after infection with dysentery. The baby experiences bloating in the abdomen, which causes discomfort and pain. This is accompanied by crying. Due to pain, the newborn may cry during bowel movements. A newborn baby’s body temperature rises, fever occurs, and clear signs of water-electrolyte imbalance appear.

Diagnosis of dysentery in a newborn

The doctor will be able to diagnose the disease by examining the newborn and taking an anamnesis, taking into account the mother’s complaints. To make an accurate diagnosis and determine the type of pathogen and the severity of the disease, bacteriological tests are prescribed. The pathogen is isolated from the feces of a newborn baby. Specialists conduct stool tests for dysbacteriosis, as well as coprocytograms.

Complications

Many parents worry about how dangerous this disease is for the newborn body? For an infant in the first month of life, dysentery is an extremely dangerous disease.

Due to weakened immunity, infection with a concomitant infection is possible. This could be another intestinal disease, a genitourinary tract infection, or pneumonia. There is a high risk of developing peritonitis and intestinal perforation. A rare, but extremely dangerous, complication of dysentery in a newborn is toxic-infectious shock. It can be fatal to the infant. Diarrhea leads to dehydration. In a newborn, dehydration develops rapidly and can quickly lead to death. Dysentery is most dangerous in weakened and premature children. With timely medical care, the prognosis for recovery is favorable. But after complete recovery, the baby can be contagious for several months.

Treatment

What can you do

Parents should not treat the disease in their newborn baby on their own. Traditional medicine methods are also not allowed. When the first signs of dysentery appear, parents should consult a doctor themselves or call an ambulance. It is necessary to reduce the amount of food consumed at a time, but increase its frequency. This applies to children who are bottle-fed. When breastfeeding, the diet can remain the same, but the baby cannot be forced to eat. You should also replenish lost fluid with water.

What does a doctor do

After receiving the diagnostic results, the doctor determines how to treat dysentery in a newborn. Antipyretics are used to reduce body temperature. To replenish lost fluid, water-electrolyte solutions are prescribed. For a newborn baby, they are usually used using droppers. Enterosorbents are prescribed to remove toxins from the body. Probiotics are used to restore damaged microflora. They are added to expressed breast milk or formula. For moderate or severe forms of dysentery, the doctor prescribes antibiotics.

Prevention

You can prevent illness in your baby by following certain preventive measures.

Parents must observe the rules of personal hygiene when caring for a newborn baby. Parents should always wash their hands before touching their baby. For a newborn baby, drinking water must be boiled. Parents need to watch for flies in the room where the baby is. Flies should be prevented from landing on children's dishes or toys. If someone infected with dysentery appears in the environment of a baby, contact with him should be completely stopped. Experts advise feeding a newborn with breast milk. It helps in increasing the effectiveness of immunity. If the child is bottle-fed, utensils should be sterilized before each feeding. It is also necessary to sterilize the pacifier. Regularly wash your newborn’s clothes and bedding at a temperature of 90 degrees. Do not visit hospitals and clinics with your baby, as well as places with large crowds of people unless absolutely necessary.

In the article you will read everything about methods of treating a disease such as dysentery in newborns. Find out what effective first aid should be. How to treat: choose medications or traditional methods?

You will also learn how untimely treatment of dysentery in newborns can be dangerous, and why it is so important to avoid the consequences. All about how to prevent dysentery in newborns and prevent complications. Be healthy!

Contents of the article

Historical data

Dysentery has been known since ancient times. There is a description of numerous epidemics dating back to the Middle Ages. The term “dysentery” was introduced by Hippocrates. The causative agent was initially considered to be an amoeba, first isolated by Lesh in St. Petersburg in 1875. Bacterial dysentery has become known since 1891, after Grigoriev discovered dysentery bacilli, studied their morphology, pathogenic properties and showed their significance in the etiology of the disease. Later, dysentery bacilli were described by Shiga and received the name Grigoriev-Shiga bacilli. Subsequently, a number of other causative agents of dysentery were described: Cruse, Flexner, etc.

Etiology of dysentery in children

The causative agents of the disease are dysentery bacteria. According to the International Classification Scheme, they belong to the genus Shigella and are divided into five species, of which the Flexner species is divided into three subspecies and a number of subtypes. Shigella are small mobile rods (1-3 microns in size) with “rounded ends, they are easily painted with aniline dyes, gram-negative, grow on ordinary nutrient media. Morphologically, different species are indistinguishable from each other, differentiated by biochemical and serological properties (these properties are relatively unstable) Grigoriev-Shiga dysentery bacilli secrete exotoxin, the rest - only endotoxin.
Dysentery germs quickly die in sunlight, drying, high temperatures, and under the influence of disinfectants. At low temperatures, in a humid environment, in the dark, they last a long time: on wet linen, pots, dishes - weeks and even months, on food - up to 15 - 30 days, in water - up to 9 days, in soil - up to 3 months .

Pathogenesis and pathological anatomy of dysentery in children

Dysentery is a general infectious disease, but local inflammatory changes develop in the large intestine, mainly in its lower section. Dysentery bacilli enter the body through the digestive tract, where they are partially destroyed. It is believed that the toxin released in this case is absorbed into the blood, mainly through the mucous membrane of the colon, which leads to sensitization with vascular changes in the form of increased permeability. The toxin is one of the factors contributing to the development of the pathological process in the intestines. In the intestines, in its mucus, in the mesenteric lymph nodes, dysentery bacilli multiply. They cause local changes; the body is affected by toxins coming from this inflammatory focus.
In the past, in severe forms, processes have been described that extend to the upper sections of the entire colon and even the adjacent part of the ileum.
The inflammatory process in the colon can be catarrhal, follicular, croupous and diphtheritic. During the catarrhal process, the intestinal mucosa becomes hyperemic, swollen, juicy, and there may be areas of small hemorrhages. Histological examination reveals areas of superficial necrosis and desquamation of the epithelium, hyperemia, edema, infiltration of leukocytes, lymphocytes, and single plasma cells not only of the mucous membrane, but also of the sublytic layer. In the lymph nodes, moderate swelling and lymphocytic infiltration are noted, in the intestinal lumen - mucus, epithelial cells, neutrophilic leukocytes, and individual red blood cells.
In the follicular form, against the background of the same catarrhal changes, inflammatory hyperplasia of the follicles is observed, which can undergo necrosis followed by ulceration.
The croupous form is characterized by the fact that ulcerative changes are accompanied by the formation of fibrinous films consisting of necrotic tissue and fibrin. With further development of the process, fibrinous exudation with deeper necrosis can penetrate into the thickness of the mucous membrane, up to the serous membrane (diphtheritic form). Reverse development occurs by rejection of the overlays with the formation of ulcers followed by scarring.
The listed forms represent stages of the inflammatory process in the colon during dysentery. Catarrhal changes are the initial, easiest ones, and the process can stop there. Other forms arise with its further development. In recent years, fibrinous forms have almost never been encountered. There are strong indications that these forms arise as complications as a result of the addition of other flora: staphylococci, fungi of the genus Candida, fusospirochetous infection, etc. (A. V. Tsinzerling).
Toxins of dysentery bacilli formed in the intestine act directly on the vascular and nervous apparatus of the intestine, on the cells of the Auerbach and Meissner plexuses, and in addition, when absorbed into the blood, they have an effect on the central nervous system.
Damage to the intestines leads to disruption of functional activity, to increased peristalsis, which is manifested by increased frequency and dilution of stools; pathological impurities appear in it in the form of mucus, leukocytes, and possibly red blood cells. As the process develops, probably due to overstimulation of receptors, a spasm of the sigmoid colon occurs at the site of inflammation, stool becomes scanty; in severe forms, the stool contains only decay products of the mucous membrane.
Damage to the autonomic centers leads to disruption of the motor and secretory activity of the entire intestine. The functional ability of the stomach, pancreas, and liver is disrupted by reflex. The complex of these changes leads to metabolic disturbances.
Dysenteric intoxication and metabolic disorders affect the cardiovascular system; metabolic disorders occur in the heart muscle and circulatory disorders. With severe intoxication, acute plethora and swelling of the brain substance, the phenomenon of general venous stagnation are determined, and dystrophic changes in internal organs are usually observed.
A rapidly developing dysentery process can quickly lead to death, directly related to specific intoxication. Recovery occurs due to the activation of immune processes; regeneration processes in the intestines without etiotropic treatment can last up to several weeks.
In weakened children, if treated incorrectly, regeneration of intestinal changes may occur sluggishly or completely absent, as a result of which dysentery takes a protracted and chronic course. In these cases, catarrhal changes are observed in the colon; there may be erosions on the mucous membranes, superficial ulcerations, cicatricial changes, and small areas of pigmentation. The formation of chronic forms is especially facilitated by exacerbations and relapses of the intestinal process, which arise mainly as a result of repeated infections. During exacerbations, the changes are the same as at the beginning of the disease, including the phenomena of intoxication.
Disturbances in the functional activity of the intestine, especially in chronic forms, lead to nutritional disorders and hypovitaminosis, which contributes to the occurrence of pneumonia, otitis media and other inflammatory processes caused by secondary infection.
In young children, morphological changes are usually not clearly expressed; they have predominantly catarrhal and follicular forms. A distinctive feature at this age is the low severity of specific toxicosis and disorders of water and mineral metabolism, which can become catastrophically violent. In this same age group, exacerbations are most frequent, caused primarily by exogenous factors.
Immunity for dysentery has not been studied enough. It has been established that after dysentery it is type-specific, short-lived, of low tension, so repeated and multiple diseases are possible.

Clinic for dysentery in children

The incubation period for dysentery lasts from several hours to 7 days (most often 2-3 days). The main clinical manifestations consist of diarrhea with colitic syndrome and general intoxication phenomena. Colitic syndrome is changes characteristic of inflammatory lesions of the colon. Its classic signs are loose stools, a relatively small amount of feces, an admixture of mucus, and streaks of blood. The phenomena of intoxication have nothing specific to dysentery. They are the same as with most other infections: fever, poor health, appetite, etc.
The onset of the disease is usually acute, with the most pronounced changes in the first days. Many patients simultaneously develop symptoms of general malaise and intestinal dysfunction. The stool becomes more frequent, becomes liquid, at first it is copious and fecal, and soon an admixture of mucus appears. On the first day, less often on the second day, due to the spastic state of the colon, stool becomes scanty, feces may completely disappear, cloudy green mucus is released, and less often streaks of blood appear in the mucus. There are cramping pains in the abdomen, especially before and during defecation, tenesmus and pliability of the anus are noted. On palpation, pain in the area of the sigmoid colon or its spasms (in the form of a dense cord) can be detected; the tongue of patients is usually coated.
At the onset of the disease, an increase in temperature is often observed - from low-grade (37.1-37.2 ° C) to high (39-40 ° C and above). Other symptoms of intoxication also have varying severity - from minor and quickly passing to extremely severe, which determines the form of the disease. This is a disturbance in well-being, appetite, and may cause nausea and vomiting. The most severe symptoms of intoxication are confusion, meningeal phenomena, convulsions, cyanosis, cold extremities. Cardiovascular weakness develops, manifested by tachycardia, muffled or deaf heart sounds, arrhythmia, and decreased blood pressure.
The severity of colitic syndrome and infectious toxicosis in the first days of the disease, as a rule, coincides, but there may be some discrepancies, especially in severe forms and in infants.
Manifestations of the disease in the acute period and subsequent course are very different, which leads to a wide variety of clinical forms, depending on the individual characteristics of children, the properties of the pathogen, the massiveness of the infectious dose and many other factors.
In the classification of dysentery, built according to generally accepted criteria, typical, erased and atypical forms are distinguished. Based on severity, they distinguish between mild, moderate and severe forms, with the toxic form being distinguished among the latter. The erased form of dysentery is distinguished as a mild form.
Depending on the duration, there are acute forms with recovery in the first 1.5-2 months from the onset of the disease and chronic forms with persistence of symptoms of the disease for more than 3-4 months. An intermediate position is occupied by the protracted form, in which the disease lasts more than 1.5-2 months, but still does not become chronic.
By nature, a smooth and non-smooth course of dysentery is distinguished in the presence of complications or concomitant diseases.
The severity of dysentery is determined mainly by intoxication. In mild forms, the general condition is almost unimpaired; the temperature may be normal or its increase is usually slight and short-lived. Since in dysentery the phenomena of intoxication and intestinal changes are directly related, although colitic syndrome exists, it is not clearly expressed. Stools are infrequent - up to 5-8 times, it may not lose its fecal character, there is an admixture of mucus, and an admixture of blood is noted only in individual portions, but may be absent. Signs of a spastic state of the sigmoid colon are also weakly expressed.
Moderate forms characterized by distinct but moderately pronounced signs of intoxication. There is an increase in temperature (up to 39 ° C and above), vomiting, mild disturbance of health, muffled heart tones, etc. Cramping pain in the abdomen, especially before defecation, tenesmus, changes in the right iliac region of the abdomen in the form of pain and often spasm of the sigmoid colon. Stools up to 10-12 times a day or more, similar to stools with colitis (mucus, streaks of blood). The temperature is elevated for 2 - 3 days. Subsequently, the disease proceeds at normal temperature; there are occasional increases within the range of low-grade fever. The severity of intestinal changes is also mitigated, feces with fewer pathological impurities appear in the stool, however, complete normalization of stool can be delayed for up to a week or more, an admixture of mucus can also be observed in normal stools.
For severe forms Dysentery is characterized by pronounced changes. In toxic forms, the phenomena of intoxication - neurotoxicosis - come to the fore, which serves as the line separating it from moderate forms. The disease begins with symptoms of intoxication, repeated repeated vomiting, high fever and other symptoms described above. Changes in stool are often delayed, and patients are often diagnosed with food intoxication or foodborne toxic infection. Loose stools may appear after a few hours; at first they are usually profuse, but quickly lose their fecal character, become very frequent, large amounts of mucus, streaks of blood and other symptoms that are part of the colitis syndrome appear. Severe toxicosis can develop extremely rapidly with convulsions, loss of consciousness, a drop in cardiac activity, with a picture of sudden vascular disorders (coldness of the extremities, pallor, cyanosis, decreased blood pressure); death may occur even before the appearance of typical intestinal changes. This is a hypertoxic form.
The abdomen of patients with the toxic form is initially slightly swollen and becomes sunken; a spastically contracted sigmoid colon is easily palpable in the left iliac region. The high temperature in these forms decreases in the coming days, but usually a low-grade fever persists. Without appropriate treatment, recovery occurs slowly; weakness, loss of appetite, and deafness of heart sounds are noted for a long time; improvement and normalization of stool is delayed. With proper intensive therapy, the temperature drops to normal in the coming days, appetite is quickly restored, stools often return to normal in the first week, and then a little mucus may sometimes appear; In many patients the disease takes an abortive course.
Severe forms may occur with a predominance of colitic intestinal changes. The general phenomena of intoxication are pronounced, but they do not reach the degree that is characteristic of toxic forms. In all forms of dysentery, especially severe ones, complete normalization of the intestinal mucosa, restoration of impaired metabolism and enzymatic activity occurs much later than clinical recovery.
Blood changes in erased mild forms are absent or insignificant; in more severe forms, leukocytosis is observed due to neutrophilia (with a shift to the left); ESR is moderately elevated or normal.
The duration of dysentery depends on the timeliness and correctness of treatment, on the condition of the child before the disease, on his age characteristics, and in addition, on the severity of dysentery. Chronic course (more than 3 - 4 months) can acquire all forms of dysentery. This is facilitated by the reduced reactivity of the child’s body, malnutrition, rickets, infestation by worms and protozoa, and accompanying inflammatory processes. One of the most common causes is repeated, repeated infection with dysentery bacilli (superinfection, reinfection).
In the chronic course, complete repair of the colon mucosa does not occur, which maintains diarrhea. There are usually no signs of intoxication, the temperature is normal. Lethargy, weakness, sometimes abdominal pain, and often decreased appetite are noted. The stool is fecal in nature, but it is liquid or semi-liquid, mucus appears constantly or occasionally, and there may also be streaks of blood.
Long-term intestinal disorders lead to enzymatic changes in the stomach, intestines, and pancreas. The listed changes can be permanent, in these cases they speak of a continuous flow. Along with this, recurrent forms are noted, which are characterized by alternating light intervals, when intestinal symptoms disappear or are insignificant, and exacerbations with the appearance of the same symptoms as at the beginning of the acute form. The chronic course of dysentery is very debilitating for the child, contributes to the development of anemia, hypovitaminosis, nutritional and metabolic disorders. Against this background, pneumonia, otitis, etc. often occur.
The unsmooth course of dysentery includes cases with complications or concomitant diseases. The most common complications are exacerbation of the intestinal process; concomitant diseases are varied, the most common are acute respiratory viral infections and inflammatory processes (pneumonia, otitis, etc.).
Dysentery in young children differs in a number of features. Colitic syndrome is observed in 80-90% of cases, but it can be mildly expressed and is often combined with dyspepsia syndrome. The stool may not lose its fecal character; it is green, with undigested food residues, often with mucus, and sometimes scanty streaks of blood are observed. Tenesmus, characteristic of older children, is replaced by anxiety, crying during bowel movements, and relaxation of the anus. The abdomen is usually not retracted, as in older children, but bloated.
Toxic forms in infants, if they occur, are extremely rare. The phenomena of primary infectious toxicosis are weakly expressed in them due to physiological hyporeactivity to microbial toxicosis. Toxicosis in this age group, according to M. G. Danilevich’s definition, is secondary, i.e., caused not by a specific microbial toxin, but by metabolic disorders that have arisen, a manifestation of a nonspecific “metabolic catastrophe.” It usually develops acutely, somewhat later than the onset of dysentery, and can also occur in the later stages of the disease; characterized by exicosis, vomiting, frequent profuse watery stools, a sharp drop in body weight, severe disturbances of water-mineral, and subsequently protein metabolism. These disorders lead to adynamia, impaired cardiovascular activity, intestinal paresis and other severe changes.
In infants the development of ileitis, ileocolitis with severe intoxication, high fever, a sharp drop in body weight, persistent vomiting, flatulence, frequent enteritis-type stools (heavy, with a lot of fluid, cloudy, fetid) is described. It has been established that such forms are usually caused by a mixed infection (combination with salmonellosis, staphylococcal infection).
An extremely important feature of dysentery in infancy is the tendency to have a non-smooth wave-like course - the occurrence of exacerbations and relapses with severe metabolic toxicosis. In their genesis, M. G. Danilevich (1949) established the following exogenous factors, which have fully retained their significance to this day:
1) nutritional (gross errors in diet);
2) superinfection (re-infection with dysentery bacilli);
3) cross enteral infection (infection predominantly with Salmonella);
4) cross parenteral infection (infection predominantly with coccal flora with the subsequent occurrence of pneumonia, otitis, etc.). In recent years, acute respiratory viral infections and intestinal viral infections (ECHO and Coxsackie) have also been considered exogenous factors. Establishing the causes of secondary waves, in most cases associated with late hospitalization, their prevention and treatment played an extremely important role in reducing mortality from dysentery in young children.
In older children, dysentery occurs in the same way as in adults; Features are noted in cases of exhaustion and hypovitaminosis. In this case, colitic syndrome is masked by changes associated with functional and metabolic disorders, frequent involvement of the small intestine in the pathological process. The stool is fecal, copious, watery, mucus may be absent or very little, tenesmus does not occur. Patients quickly lose their appetite, become weaker, and lose weight, but despite the severity of the condition, there may be no signs of intoxication (fever, nausea, vomiting, etc.).

Complications of dysentery in children

Complications caused directly by dysentery bacilli are very rare. With deep local damage, intestinal bleeding, intestinal perforation followed by peritonitis, pericolitis, adhesions, and cicatricial strictures are described. In young children, rectal prolapse may occur. Arthritis, iritis, iridocyclitis, and complications of the nervous system in the form of neuritis and encephalitis were noted. Their connection directly with dysentery bacilli is not well understood.
Exacerbations of the disease are manifested by symptoms characteristic of dysentery in the initial period. They can occur at different stages of the disease. The main causes are superinfection or reinfection. The genesis of relapses is the same. It is natural for dysentery, as well as for other intestinal infections, to develop dysbiosis.
With a prolonged and chronic course, malnutrition, hypovitaminosis, anemia, etc. can develop.
In young children, frequent complications caused by secondary infection are pneumonia, otitis media, pyoderma, stomatitis, etc.

Diagnosis of dysentery in children

To establish a diagnosis of dysentery, a comprehensive examination is necessary. It is important to take into account the epidemiological situation and clinical picture of the disease. An acute onset, increased temperature, frequent loose, scanty stools mixed with mucus, streaked with blood, tenesmus, and in infants their equivalents speak primarily of dysentery. A variety of laboratory methods play an important role in recognizing this disease. Pathological changes in the mucous membrane of the colon can be detected using coprogram and sigmoidoscopy.
The most accurate confirmation of the diagnosis is the isolation of the pathogen (Shigella) or the determination of specific immunological changes in the body in the agglutination reaction (RA), indirect hemagglutination reaction (IHA), and carbon agglomeration reaction.

Prognosis of dysentery in children

The prognosis depends on the state of the macroorganism, the nature of the treatment and the conditions in which the patient is located. Young children with any concomitant diseases suffer from dysentery worse. Severe forms of dysentery, developing as a foodborne toxic infection with pronounced symptoms of intoxication, are dangerous. Currently, there are all possibilities for the successful treatment of patients with dysentery; In Leningrad, for many years now there have been no deaths from this disease. The prognostication of the formation of chronic forms is unfavorable, but their number can be reduced to isolated cases.