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

Dysentery is a common bacterial bowel infection that is diagnosed in children. This disease is most common among preschoolers.. This can be attributed to the fact that older children adhere to hygiene more, do not pull toys and fingers into their mouths. Of all the cases of dysentery, the main percentage is preschool children. In order not to confuse this dangerous disease with a simple indigestion, parents need to know the main symptoms of dysentery in children under one year old and older. This will help to quickly diagnose and start the right treatment.

Ways of infection

The disease is caused by bacteria of the genus Shigella. These pathogenic microorganisms multiply well in any environment - water, soil, on food products, they tolerate low-temperature conditions well. These bacteria are sensitive to heat, disinfectants, and exposure to direct sunlight. When boiled, Shigella die 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 excreted 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 - by eating poorly washed vegetables or fruits;
Contact household - transmitted through kitchen utensils, bedding, various toys and household items.

A large number of cases of dysentery are registered in the summer-autumn period when a lot of fruits, berries and vegetables are consumed. 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 are named after the scientists who first discovered them:

Sonne.
Flexner.
Grigorieva-Shiga.
Boyd.

The causative agents of dysentery differ in different areas. In European countries, Sonne's bacillus causes dysentery, and Flexner's dysentery is slightly less commonly diagnosed in children. In the countries of Central Asia and the Far East, the disease is caused by the Grigoriev-Shiga wand and is quite difficult.

Most often, infection occurs if raw water, unboiled milk and other products without heat treatment are used. The risk of infection also arises from the use of 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 the baby.

If a patient with shigella did not wash his hands after visiting the bathroom, then he transfers the causative agent of the disease to all the objects he touched on his hands. Dysentery in children will occur if the child takes an infected household item, and then pulls his hands into his mouth.

The susceptibility of children to dysentery is very high, 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 Grigorieva-Shiga produce toxins into the bloodstream while still alive, other pathogens release toxic substances when they die. Immunity after suffering dysentery does not remain, 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 amount of the pathogen, when it enters the digestive tract, dies and at the same time throws in toxic substances. They are absorbed into the blood and, acting on the wall of blood vessels, increase their permeability. This causes pathological conditions in the intestines. Shigella reproduction occurs 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, small hemorrhages are noticeable.
Severe course of the disease - superficial necrosis of the mucosa 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 on 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 stools, the appearance of mucus and bloody inclusions in the stool, and soreness of the affected parts of the intestine. The toxins released by the dysentery bacillus affect the vessels and nerve cells not only in the intestines, but also in the central nervous system.

Due 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 malfunctions in the cardiovascular system and pathological changes in various organs.

Therefore, if dysentery is diagnosed in a child or an adult, then this disease should not be taken lightly. Quite serious complications can occur, which will require more than one month of treatment.

Severe intoxication of the body can cause death in debilitated children. Of particular danger is dysentery in infants, with low body weight, dehydration quickly occurs, which leads to irreversible consequences.

Symptoms of dysentery

Signs of dysentery in a child usually appear more than in adults, and the disease itself is much more severe. The incubation period can be from three hours to a week - it depends on the amount of the pathogen that has entered the body. Shigellosis can occur usually or atypically, have a smooth course, or give severe complications. The duration of the disease is also different. 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 Sonne's stick, 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, repeated vomiting is possible.
The child becomes lethargic, he 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 illness, the stools are profuse and liquid, the next day they become scanty. You can see greens, mucus and streaks of blood in them. With a severe course of the disease, fecal masses are absent, only greenish mucus comes out in a small volume. Dysentery is characterized by false urge to go to the toilet.

Constant tension in toddlers can lead to anal gaping, most commonly seen in children who are 2 years old or younger. In rare cases, when straining, a prolapse of the rectum can occur, 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 hardly changes. Defecation becomes more frequent up to 8 times a day, but the bowel movements are not very rare and contain a little mucus. With this course, the condition improves in a few days, the temperature is rare.

Moderate form

Intoxication is manifested by mild symptoms. Body temperature rises during the first days to 39, then stabilizes. Vomiting occurs, the child complains of severe pain in the abdomen. Defecation occurs more than 10 times a day, there is mucus and blood blotches in the stools. The condition returns to normal after a week, but even in the formed feces, mucus may be present for a long time.

Severe form

Symptoms appear more from the intestines, although intoxication is also present.. Stools with abnormal impurities, the child goes to the toilet more than 15 times a day. There is a high temperature, which, with proper therapy, drops to a value of 37.5 and lasts for a long time, as well as weakness with poor appetite. The intestinal mucosa recovers for a very long time, diarrhea stops after a week.

toxic form

It is manifested by severe intoxication of the whole organism. There is repeated vomiting, general weakness and fever. Most often, with this form of the disease, a food infection is diagnosed, because there is no diarrhea. Loose stools occur a couple of hours after the first symptoms and quickly become scanty, with mucus and blood streaks. The baby's tummy sinks a little, you can feel the tense rectum.

Hypertoxic form

With this form, disturbances in the work of the cardiovascular system are characteristic.. There may be convulsions and fainting.

The skin becomes bluish, the limbs become cold 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 invasion.. Re-infection with Shigella can lead to the chronic form of the disease. This form occurs with a slight intoxication of the body - the child is weakened, he has a poor appetite, there are pains in the lower abdomen and rare stools. But body temperature is normal. Other digestive organs are often involved in the disease, so metabolism is disturbed.

Features of the course of the disease in infants

In babies under 1 year old, an infectious disease has a number of features:

Symptoms come on gradually. The stools are rare, very offensive and mixed with mucus.
The abdomen does not retract, but swells.
The baby is restless, crying a lot during defecation.
Often a secondary infection develops - pneumonia or otitis media.

Indomitable vomiting and diarrhea quickly lead to dehydration of the baby. Absorption of proteins is disturbed, flatulence and malfunctions of the heart occur. Convulsions and fainting are possible. In 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 age of the patient and the form of the disease, as well as some factors. Treatment of dysentery in children at home is allowed only with a mild course of the disease., and if there are no other children in the family who can become infected. Also, there should not be people in the house that work in the food industry and child care facilities. Comprehensive treatment is carried out, which consists of the following activities:

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

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

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

If the child has severe dehydration, then he is carefully soldered. For this purpose use ordinary water, teas, decoctions of dried fruits, compotes and jelly. Well helps rice water, which is often given in small portions. In a hospital, intravenous administration of solutions - glucose and saline is indicated.

With severe pain in the abdomen, antispasmodics are prescribed. With 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 be in the hospital with dysentery, only the attending physician decides. But therapy is continued until all symptoms disappear and the test results are good.

Diet during the rehabilitation period

A diet for dysentery in children is prescribed immediately after the acute symptoms subside. Therapeutic starvation in children is not practiced now, food is given in small portions. If the baby is artificially fed, then it is temporarily transferred to fermented milk products.

For children older than a year, porridge is cooked from oatmeal, buckwheat and rice. You can give vegetable puree soups, as well as steamed meat products. Well normalizes digestion applesauce, which contains pectin.

After a child has had dysentery, he should not eat fried and smoked foods for about two months. As well as 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 come down to compliance with hygiene rules:

Hands must be washed after the street and going to the toilet.
Vegetables, fruits and berries are thoroughly washed with running water, and then rinsed with boiling water.
Do not eat foods of dubious quality.
If a case of dysentery is registered in the children's group, then quarantine is introduced.
The dishes for feeding the artificial child are well washed and doused with boiling water.

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

Children are highly susceptible to various diseases. Among the common diseases among young patients is dysentery. This intestinal infectious disease is also called the disease of dirty hands, since the main reason for 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. Mostly these are preschoolers (from 2 to 7 years old), who often put various objects or their own pens into their mouths.

How dysentery is transmitted: ways of transmission, causes

The main cause of acute intestinal disease are various types of pathogens of the genus 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-household.

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

Water can also be a source of infection. Basically, infection occurs through the use of raw (that is, unboiled) liquid, especially from unreliable sources. For example, well or spring drinking is often contaminated with feces that penetrate from the soil into groundwater.

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

How to determine that a child has dysentery: symptoms

The clinical manifestation of an acute intestinal ailment depends on many factors: the type of bacteria, the degree of infection, the age of the patient, the state of his immune system, the presence of concomitant pathological processes.

At the initial stage of development, the disease is manifested by general malaise, weakness, fever, nausea and vomiting. Later, the main symptoms are complicated by bowel disorders. In some children, an infectious disease immediately begins with intestinal disorders, which are manifested by painful sensations in the abdomen and diarrhea, while children's feces remain fecal in nature, 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 the signs of bacterial infection in children of the first year of life. Firstly, they still cannot tell their parents about their health problems on their own. Secondly, the clinical manifestation of an infectious disease has a slightly different character:

gradual development of colitis syndrome;
violation of the normal activity of the gastrointestinal tract;
the fecal nature of the stool is preserved;
green color of feces with mucus and lumps of undigested food, in rare cases, bloody streaks may appear;
fetid stool;
bloating;
pain during defecation.

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

What to do if a child has dysentery

It is impossible to cure dysentery on your own without medical help. Therefore, the first thing parents should do when they find signs of infection is to show the child to the 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.

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

Antibiotics

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

However, do not forget that it is forbidden and dangerous to treat a baby with antibiotics on its own. 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 take into account that Mother Nature's medicines bring results only if the therapy is carried out in a complex manner, so do not forget to discuss this issue with your doctor before using them.

It is very important for an infectious infection to give the child as much to drink as possible. And in this case, recipes for folk therapy come to the rescue. Small patients are recommended to give various decoctions, for example, rice, chamomile, apple. Also useful in the treatment of dysentery is rice porridge boiled in water without adding salt.

Diet

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

cereals (semolina, oatmeal, rice);
steam products (cutlets);
vegetable soups;
grated apple;
kissels, 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 on artificial feeding, then give preference to fermented milk mixtures.

From the second week of treatment, if the doctor allows, the nutritional diet of a small patient can be gradually expanded. However, spicy, salty, fried and fatty foods should be avoided for about 2-3 months after recovery.

Where and how to treat the baby - only the doctor decides. The main task of dad and mom is the strict implementation of all medical recommendations. Home treatment implies compliance with all measures to prevent infection of others, and care 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 and hygienic regimen;
control the intake of medications prescribed by the doctor;
Provide your child with a balanced diet.

Urgent Care

If the patient has symptoms of an acute intestinal disease (diarrhea with blood, high fever), it is necessary to act immediately. What can you do:

contact a doctor and call an ambulance;
give the child as much to drink as possible, the best drink in this situation will be boiled water with the addition of sugar (2 tbsp) and salt (1 tbsp);
do not give the baby any medication without the permission of the doctor - this can complicate the course of the disease and harm the little patient;
isolate a sick child from the household and control 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 occur and, in fact, the development of dysentery is complicated. With deep intestinal damage in a child, the following complications may occur:

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

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

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

Especially for - Marina Amiran

The children's organism is especially susceptible to causative agents of intestinal infections. Most parents try to instill hygiene habits in them from the first months of life. However, it is not always possible to keep track of whether the child washed his hands, especially if he is visiting, 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 for which symptoms you should see a doctor.

Content:

Features of the disease

Dysentery is an intestinal disease in which the infection affects the large intestine (sigmoid colon). Substances secreted by microbes corrode the mucous membrane and poison the entire body. The case of a child's illness can be a single one, but seasonal infectious outbreaks often occur (especially in child care facilities).

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 you need to wash your hands often. A small child does not yet have such skills. Children of preschool age are most often ill. In infants, the disease is observed very rarely, mainly if they are fed with milk formulas or the body is weakened due to the presence of diathesis, anemia, rickets.

Types of pathogens of dysentery, ways of infection

Dysentery is caused by enterobacteria called Shigella. There are several types of these bacteria. Some of them are less aggressive (Shigella Sonne), the disease they cause is milder. Others (Shigella Flexner) are the 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 food for 1 month, they do not die when dried. They can be found on dishes, clothes, various household items.

The most common cause of infection of a child with dysentery is contact with a sick person. The bacteria are on his hands if he didn't wash them after going to the toilet, on clothes or towels that he touched. Some people can carry the bacteria even though they don't get sick themselves.

Note: The well-known pediatrician E. Komarovsky emphasizes that the spreaders of dysentery are often people who are not serious about the symptoms of the disease that appear in them. Having stopped diarrhea with the help of pills, they remain carriers of bacteria, infecting those around them, first of all, babies.

Dysentery sticks are excreted from the body with feces. Infection occurs by the fecal-oral or contact-household route. In this case, the source of infection can be poorly washed vegetables raised from the ground, as well as water from natural reservoirs that got into the mouth while bathing, or products that have not undergone sufficient heat treatment.

The causative agents of dysentery do not withstand boiling, they die already at a temperature of 60 ° after half an hour of heating. They are detrimental to direct sunlight, as well as disinfectants.

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

Permanent immunity to this disease is not produced, so the risk 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 amoebas, protozoa, cause intestinal damage. Due to the similarity of symptoms, this disease is called amoebic dysentery. However, there are distinctive features of its course and treatment. Amoebas are introduced into the wall muscle, forming abscesses. A disease of this type is classified as 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;
non-compliance with the rules of personal hygiene;
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 patients or carriers of bacteria;
bathing in natural reservoirs, as well as getting sand or soil into the child's mouth from objects that he uses on the street.

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 secreted by dysentery bacteria in the intestine cause inflammation in its mucosa. Being absorbed through the walls of blood vessels into the blood, they are carried to other organs, which leads to the appearance of 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. Symptoms may be overt (typical) or latent (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 does not go away for a longer time. Then they talk about the appearance of chronic dysentery in children.

Light form

It leads to the formation of small areas of hemorrhage, which occurs due to erosion of the blood vessels of the mucosa. The child has a slight increase in body temperature. He defecates more often than usual (up to 8 times a day), while a little mucus appears in liquid feces, there are no blood impurities.

Illness of moderate severity

The child has inflammation of the mucosa, swelling occurs, its ulceration begins. Within 3 days, the temperature is kept up to 39 °, the chair becomes more frequent up to 10-15 times a day, pulling cramping pains appear in the lower abdomen, vomiting occurs. The baby feels unwell for about a week, after appropriate treatment, the symptoms disappear.

Severe form

There is necrosis of individual sections of the intestinal lining. Ulcers appear at the site of the discharge of dead cells. The deeper layers of the intestinal wall are affected, and other pathogens (staphylococci, streptococci, fungi) also enter them. The muscles of the intestinal wall spasmodically contract. Symptoms of intoxication are less pronounced.

The temperature does not exceed 37.5°, lasts for a long time. There is blood and a lot of mucus in the stool. The frequency of bowel movements is more than 15 times a day. The child has rumbling in the stomach, weakness appears. Due to the fact that there are frequent false urges, the baby is pushing hard, he has swelling in the anus (the so-called "anus gaping"). Even a small bowel prolapse may occur.

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

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 at the first moment may not even suspect dysentery, since frequent urge to defecate, change in stool and abdominal pain appear only a few hours after the first manifestations of ill health. Abundant liquid stools gradually become scanty, but very frequent, it contains mucus and blood. Because of the cramps in the abdomen, severe pain is felt, it looks sunken.

Hypertoxic

This is an extremely severe form of dysentery. The child has convulsions, he may lose consciousness. The work of the heart is disturbed, the heartbeat slows down, blood pressure drops. The skin turns pale. Limbs turn blue and cold. The likelihood of death is high, especially in very young children.

Features of chronic dysentery

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

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

Chronic manifestations may be the result of a protracted course of the disease, but also occur with re-infection with a dysentery bacillus.

The child has a normal temperature. But often there is causeless diarrhea, spasmodic pain below the navel. There is mucus in the stool, sometimes there is blood. The baby has a poor appetite, he gets tired quickly. Violation of digestion leads to the development of beriberi and anemia.

These symptoms may occur continuously (continuous) or intermittently (recurrent).

How is dysentery in infants

In young children, dysentery is more manifested by symptoms of dehydration (due to vomiting and diarrhea), as well as exposure to 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 condition of the baby and the periodic resumption of symptoms.

Unlike older children, infants do not experience retraction, but bloating. The emptying of the intestines is painful for him, in addition, irritation of the anus is observed, therefore, during a bowel movement, he cries. There is a liquid green stool with a strong unpleasant odor, 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, weakens, he may have convulsions. If you do not start emergency treatment, heart and kidney failure occurs.

When to urgently call a doctor

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 contact a doctor. Moreover, it is unacceptable to self-medicate, to try to stop diarrhea in any way, losing precious time, complicating the course of the disease.

The doctor should be called to the house, as the patient is contagious. This is done when symptoms such as fever, weakness, flatulence (the presence of stench in the outgoing gases), headache, chills, abdominal cramps, loose stools appear (and it may not appear immediately). The baby has an increased urge to defecate, 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 lumen of the rectum up to the appearance of obstruction. Vascular damage causes life-threatening internal bleeding. Ulceration of the intestinal wall contributes to the penetration of bacteria into the abdominal cavity and the development of peritonitis.

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

Diagnostics

The diagnosis is based on the results of laboratory tests of feces and vomit. The usual examination methods are:

Coprogram (examination of feces under a microscope to detect blood, protein, fats, particles of muscle tissue in it). This method allows you to assess the degree of damage to the mucosa and destruction of the intestinal wall.
Bacteriological culture of faeces and vomit. Produced to clarify the type of bacteria, the choice of an antibacterial agent.
Immunological tests (ELISA, for example) to detect antibodies to dysenteric bacillus.
PCR analysis (determining the type of pathogen by its DNA).
Sigmoidoscopy - examination of the rectum with 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 other intestinal disease.

Treatment

First of all, when dysentery is detected in children, antibiotics are prescribed (ampicillin, gentamicin, furazolidone). In addition, funds 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, babies are given papaverine or no-shpu, and to maintain the pancreas - pancreatin, festal. Means that restore the intestinal microflora (bifidumbacterin, lactofiltrum), sorbents (espumizan or enterosgel from bloating), as well as various 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, steam cutlets. Whole milk, raw vegetables, black bread, legumes, cabbage are excluded from the diet.

Formula-fed babies are recommended to be fed with yogurt diluted with rice water.

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

Prevention of dysentery

In order to prevent dysentery in children, parents must follow some rules. First of all, create normal sanitary living conditions for the child, teach him to wash his hands often.

Children's food should be freshly prepared. It must be kept in the refrigerator. You can not give the child expired products, buy food in street stalls. Milk bought on the market must be boiled. Water the child can be given only boiled or bottled.

Do not allow a small child to swim in a pond or river, where he can accidentally swallow contaminated water. The kid needs to be explained from an early age why it is necessary to wash his hands after using the toilet and before eating. Fruits and vegetables intended for feeding a child must not only be washed, but poured over with boiling water. This will quickly kill the bacteria.

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

Premature and underweight 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 infection 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, clothes, bedding. The infection can enter the newborn body through running water if the baby drinks it. Flies are carriers of an acute intestinal disease. They can sit on baby dishes, toys, clothes, or the newborn baby itself.

Symptoms

You can determine the disease in an infant by the signs that have arisen.

Dysentery in a newborn begins abruptly. The stool in babies becomes liquid with an admixture of cloudy mucus, as well as greenery. Blood may appear in the stool, but usually it occurs 3-4 days after infection with dysentery. The baby has bloating, which causes him discomfort and pain. This is accompanied by crying. Because of the pain in the newborn during the act of defecation, crying occurs. In a newborn baby, the body temperature rises, fever occurs, there are clear signs of a violation of the water and electrolyte balance.

Diagnosis of dysentery in a newborn

The doctor will be able to diagnose the disease when 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 studies are prescribed. Isolation of the pathogen comes from the feces of a newborn baby. Specialists analyze feces for dysbacteriosis, as well as coprocytograms.

Complications

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

Due to the weakening of the immune system, infection with a concomitant infection is possible. It could be another intestinal disease, a urinary 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 an infant. Diarrhea leads to dehydration. In a newborn, dehydration develops rapidly and can lead to death in a short time. The most dangerous dysentery in debilitated and premature babies. With timely medical assistance, the prognosis for recovery is favorable. But after a full recovery, the baby can be contagious for several months.

Treatment

What can you do

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

What does a doctor do

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

Prevention

It is possible to prevent the disease in a baby if certain preventive measures are observed.

Parents should follow the rules of personal hygiene when caring for a newborn baby. Parents should always wash their hands before touching the 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 not be allowed to land on children's dishes or toys. If an infected with dysentery appears in the environment of the baby, you should completely stop contact with him. Experts advise breastfeeding your newborn. It helps in improving the effectiveness of immunity. If the child is bottle-fed, the dishes should be sterilized before each feeding. It is also necessary to sterilize the pacifier. Regularly wash clothes and bedding for a newborn at a temperature of 90 degrees. Do not visit hospitals and clinics with the baby, as well as places with large crowds of people without urgent need.

In the article you will read everything about the methods of treating a disease such as dysentery in newborns. Specify what effective first aid should be. How to treat: choose drugs or folk 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!

The content 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 first considered an amoeba, first isolated by Lesh in St. Petersburg in 1875. Bacillary 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 sticks were described by Shiga and were called Grigoriev's sticks - Shiga. Subsequently, a number of other causative agents of dysentery have been described: Cruse, Flexner, etc.

Etiology of dysentery in children

The causative agents of the disease are dysenteric 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 movable sticks (1-3 microns in size) with "rounded ends, they are well painted with aniline paints, 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).Dysentery sticks Grigoriev-Shiga secrete exotoxin, the rest - only endotoxin.
Dysentery microbes quickly die in sunlight, when dried, at high temperature, under the influence of disinfectants. At low temperatures, in a humid environment, in the dark, they remain for 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 common infectious disease, but local inflammatory changes develop in the large intestine, mainly in its lower section. Dysentery sticks enter the body through the digestive tract, where they are partially destroyed. It is believed that the released toxin is absorbed into the bloodstream, mainly through the colonic mucosa, which leads to sensitization with vascular changes in the form of increased permeability. Toxin is one of the factors contributing to the development of the pathological process in the intestine. In the intestine, in its mucus, in the mesenteric lymph nodes, dysentery sticks multiply. They cause local changes, the body is affected by toxins coming from this inflammatory focus.
In the past, in severe forms, processes were described that spread to the upper sections of the entire large intestine and even to 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, there may be areas of small hemorrhages. Histological examination reveals areas of superficial necrosis and desquamation of the epithelium, hyperemia, edema, infiltration with leukocytes, lymphocytes, and single plasma cells not only of the mucous membrane, but also of the subdelisous layer. In the lymph nodes, moderate edema and lymphocytic infiltration are noted, in the lumen of the intestine - mucus, epithelial cells, neutrophilic leukocytes, individual erythrocytes.
In the follicular form, against the background of the same catarrhal changes, inflammatory hyperplasia of the follicles is observed, which may undergo necrosis followed by ulceration.
The croupous form is characterized by the fact that the formation of fibrinous films, consisting of necrotic tissues and fibrin, joins the ulcerative changes. With the further development of the process, fibrinous sweating with deeper necrotization can penetrate into the thickness of the mucous membrane, up to the serous membrane (diphtheritic form). The reverse development occurs by rejection of overlays with the formation of ulcers, followed by scarring.
The listed forms represent the stages of the inflammatory process in the colon with dysentery. Catarrhal changes are the initial, the easiest, and the process can stop on them. Other forms arise with its further development. In recent years, fibrinous forms almost never occur. There are strong indications that these forms already arise as complications as a result of the addition of another flora: staphylococci, fungi of the genus Candida, fusospirochetal infection, etc. (AV 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, being absorbed into the blood, they have an effect on the central nervous system.
Damage to the intestine leads to a violation of functional activity, to increased peristalsis, which is manifested by increased frequency and thinning of the stool; pathological impurities appear in it in the form of mucus, leukocytes, and there may be erythrocytes. As the process develops, probably due to overstimulation of the receptors, a spasm of the sigmoid colon occurs in the focus of inflammation, the stool becomes scanty; in severe forms, the stool contains only decay products of the mucous membrane.
The defeat of the vegetative centers leads to a violation of the motor and secretory activity of the entire intestine. In a reflex way, the functional ability of the stomach and pancreas, liver is disturbed. The complex of these changes leads to metabolic disorders.
Dysentery intoxication and metabolic disorders affect the cardiovascular system; there are metabolic disorders in the heart muscle, circulatory disorders. With severe intoxication, acute plethora and swelling of the brain substance are determined, the phenomena of general venous stasis, 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 intestine without etiotropic treatment can last up to several weeks.
In debilitated children with improper treatment, the 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 large intestine, 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, relapses of the intestinal process, which occur 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.
Violations of the functional activity of the intestine, especially in chronic forms, lead to eating disorders, hypovitaminosis, which contributes to the occurrence of pneumonia, otitis and other inflammatory processes caused by a secondary infection.
In young children, morphological changes are usually not pronounced, they have predominantly catarrhal and follicular forms. A distinctive feature at this age is the low severity of specific toxicosis and disturbances in water and mineral metabolism, which can become catastrophically violent. In the same age group, exacerbations are most frequent, caused mainly by exogenous factors.
Immunity in dysentery is not well understood. It has been established that after dysentery it is type-specific, short-lived, of low tension, therefore, repeated and multiple diseases are possible.

Clinic of 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 colitis syndrome and general intoxication. Colitis syndrome is a change characteristic of an inflammatory lesion 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 in most other infections: fever, impaired 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 plentiful, fecal, soon an admixture of mucus appears. On the first day, less often on the second day, due to the spastic condition of the large intestine, the stool becomes scarce, the feces can completely disappear, cloudy mucus with greenery is released, less often streaks of blood appear in the mucus. There are cramping pains in the abdomen, especially before and during defecation, tenesmus, anus compliance are noted. On palpation, pain in the sigmoid colon or its spasms (in the form of a dense cord) can be determined, the tongue in patients is usually lined.
At the onset of the disease, there is often an increase in temperature - from subfebrile (37.1-37.2 ° C) to high (39-40 ° C and above). Other symptoms of intoxication also have different severity - from minor and quickly passing to extremely severe, which determines the form of the disease. This is a violation of well-being, appetite, there may be nausea, vomiting. The most severe symptoms of intoxication are confusion, meningeal phenomena, convulsions, cyanosis, cold extremities. Cardiovascular weakness develops, manifested by tachycardia, muffled or dull heart sounds, arrhythmia, and a decrease in blood pressure.
The severity of the colitis syndrome and infectious toxicosis in the early days of the disease usually coincides, but there may be some discrepancies, especially in severe forms and in infants.
The manifestations of the disease in the acute period and the 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 commonly accepted criteria, typical, obliterated and atypical forms are distinguished. By severity, light, moderate and severe forms are distinguished, with the toxic form being distinguished among the latter. As a kind of mild form, an erased form of dysentery is isolated.
Depending on the duration, acute forms are distinguished with recovery in the first 1.5-2 months from the onset of the disease and chronic forms, with the preservation of the symptoms of the disease for more than 3-4 months. An intermediate position is occupied by a protracted form, in which the disease lasts more than 1.5-2 months, but still does not become chronic.
By nature, a smooth and uneven 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 not disturbed, the temperature may be normal or its increase is usually insignificant and short-term. Since intoxication and intestinal changes are directly related to dysentery, the colitis syndrome, although present, is not pronounced. The stool is 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 separate portions, but may be absent. Weakly expressed and signs of spastic condition of the sigmoid colon.
Moderate forms characterized by distinct, but moderately pronounced signs of intoxication. There is an increase in temperature (up to 39 ° C and above), vomiting, a mild disturbance of well-being, muffled heart tones, etc. Cramping pains 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. Stool up to 10-12 times a day or more, similar to stool in colitis (mucus, streaks of blood). The temperature is raised within 2 - 3 days. In the future, the disease proceeds at normal temperature, there are separate increases within subfebrile condition. The severity of intestinal changes also softens, fecal masses appear in the stool with a smaller amount of pathological impurities, however, complete normalization of the stool can be delayed up to a week or more, an admixture of mucus can also be observed with a formalized stool.
For severe form dysentery is characterized by pronounced changes. In toxic forms, the phenomena of intoxication, neurotoxicosis, come to the fore, which serves as a line that separates it from moderate forms. The disease begins with the phenomena of intoxication, repeated repeated vomiting, high fever and other symptoms described above. Changes in the stool are often delayed, and patients are often diagnosed with food intoxication, food poisoning. Loose stools may appear after a few hours, at first it is usually plentiful, but quickly loses its fecal character, becomes very frequent, a large amount 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 sharp vascular disorders (cold extremities, pallor, cyanosis, lowering blood pressure); death may occur even before the appearance of typical intestinal changes. This is the hypertoxic form.
The stomach of patients with a toxic form, at first slightly swollen, becomes sunken, in the left iliac region, a spastically reduced sigmoid colon is easily palpated. The high temperature in these forms decreases in the coming days, but subfebrile temperature usually persists. Without appropriate treatment, recovery comes slowly, weakness, loss of appetite, deafness of heart tones are noted for a long time; improvement and normalization of the stool are delayed. With proper intensive care, the temperature in the coming days drops to normal, appetite is quickly restored, stools often return to normal in the first week, and a little mucus may sometimes appear in the future; in many patients the disease takes an abortive course.
severe forms may occur with a predominance of colitis intestinal changes. The general phenomena of intoxication are expressed, but they do not reach the degree that is characteristic of toxic forms. In all forms of dysentery, especially in severe cases, complete normalization of the intestinal mucosa, restoration of impaired metabolism, enzymatic activity occurs much later than clinical recovery.
Changes in the blood 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 the course 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, invasion by worms and protozoa, concomitant inflammatory processes. One of the most common causes is repeated, repeated infection with dysenteric bacilli (superinfection, reinfection).
In the chronic course, complete repair of the colonic mucosa does not occur, which maintains diarrhea. The phenomena of intoxication are usually absent, the temperature is normal. Lethargy, weakness, sometimes abdominal pain, often decreased appetite are noted. The stool has a fecal character, but it is liquid or semi-liquid, mucus appears constantly or at times, and there may be streaks of blood.
Prolonged intestinal disorders lead to enzymatic changes in the stomach, intestines, and pancreas. These 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 phenomena 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 exhausting for the child, contributes to the development of anemia, hypovitaminosis, malnutrition, and metabolism. Against this background, pneumonia, otitis, etc., often occur.
The uneven course of dysentery includes cases with complications or concomitant diseases. Of the complications, there is mainly an exacerbation of the intestinal process; concomitant diseases are diverse, the most frequent OVRI, inflammatory processes (pneumonia, otitis media, etc.).
Dysentery in young children differs in a number of features. The colitis syndrome is observed in 80-90% of cases, however, 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 remnants, often with mucus, sometimes scanty streaks of blood are observed. Tenesmus, characteristic of older children, is replaced by anxiety, crying during defecation, relaxation of the anus. The abdomen is usually not drawn in, as in older children, but swollen.
Toxic forms in infants, if they occur, are extremely rare. The phenomena of primary infectious toxicosis in them are weakly expressed due to physiological hyporeactivity to microbial toxicosis. Toxicosis in this age group, according to the definition of M. G. Danilevich, is secondary, that is, due not to a specific microbial toxin, but to metabolic disorders that have arisen, a manifestation of a nonspecific “metabolic catastrophe”. It usually develops acutely, somewhat later than the onset of dysentery, and may occur in the later stages of the disease; characterized by exsicosis, vomiting, frequent copious watery stools, a sharp drop in body weight, severe violations of water-mineral, and subsequently protein metabolism. These disorders lead to adynamia, impaired cardiovascular activity, intestinal paresis and other severe changes.
In infants described the development of ileitis, ileocolitis with a sharp intoxication, high fever, a sharp drop in body weight, persistent vomiting, flatulence, frequent stools such as enteritis (copious, with a large amount of liquid, cloudy, fetid). 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 a non-smooth undulating 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 at the present time:
1) alimentary (gross errors in the diet);
2) superinfection (re-infection with dysentery bacilli);
3) cross-enteral infection (infection mainly with salmonella);
4) cross-parenteral infection (infection mainly with coccal flora, followed by the occurrence of pneumonia, otitis media, etc.). In recent years, OVRI and intestinal viral infections (ECHO and Coxsackie) are also considered exogenous factors. Establishing the causes of secondary waves, in most cases associated with late hospitalization, their prevention and treatment have played an exceptionally large role in reducing mortality in dysentery in young children.
In older children, dysentery proceeds in the same way as in adults; features are noted with exhaustion, hypovitaminosis. The colitis 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, weaken, lose weight, but, despite the severity of the condition, intoxication phenomena (fever, nausea, vomiting, etc.) may not be.

Complications of dysentery in children

Complications caused directly by dysentery sticks are very rare. With a deep local lesion, intestinal bleeding, intestinal perforation followed by peritonitis, pericolitis, adhesions, cicatricial strictures are described. In young children, rectal prolapse may occur. Arthritis, iritis, iridocyclitis, complications from the nervous system in the form of neuritis, encephalitis were noted. Their connection directly with dysentery sticks is not sufficiently elucidated.
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. Such is the genesis of relapses. It is natural for dysentery, as well as for other intestinal infections, the development of dysbacteriosis.
With a protracted and chronic course, malnutrition, hypovitaminosis, anemia, etc. can develop.
In young children, frequent complications due to secondary infection are pneumonia, otitis media, pyoderma, stomatitis, etc.

Diagnosis of dysentery in children

To establish the diagnosis of dysentery, a comprehensive examination is necessary. It is important to take into account the epidemiological situation and the clinic of the disease. Acute onset, fever, frequent loose stools mixed with mucus, streaked with blood, tenesmus, and in infants their equivalents, speak primarily of dysentery. An important role in the recognition of this disease is played by a variety of laboratory methods. Pathological changes in the mucous membrane of the colon can be detected using a 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), the reaction of indirect hemagglutination (RIGA), the reaction of coal agglomeration.

Forecast 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. Worse endure dysentery young children with any concomitant diseases. Severe forms of dysentery, which develops as food poisoning with severe symptoms of intoxication, are dangerous. Now there are all possibilities for successful treatment of patients with dysentery; in Leningrad, for many years now, there have been no lethal outcomes with this disease. The formation of chronic forms is unfavorable prognostically, but their number can be reduced to isolated cases.