Diarrhea (peds): Difference between revisions
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== | == Causes == | ||
{| cellspacing="1" cellpadding="3" border="0" bgcolor="#666666" width="100%" | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Infection | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Viral: rotavirus, Norwalk virus, enteroviruses, astroviruses, adenoviruses, caliciviruses | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Bacterial: ''Salmonella'', ''Shigella'', ''Yersinia'', ''Campylobacter'', ''Escherichia coli'', ''Aeromonas hydrophila'', ''Vibrio'' species, ''Clostridium difficile'', tuberculosis | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Parasitic: ''Giardia lamblia'', ''Entamoeba histolytica'', ''Cryptosporidia'' | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Dietary disturbances | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Overfeeding, food allergy, starvation stools | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Anatomic abnormalities | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Intussusception, Hirschsprung disease, partial obstruction, appendicitis, blind loop syndrome, intestinal lymphangiectasia, short bowel syndrome | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Inflammatory bowel disease | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Malabsorption or secretory diseases | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Cystic fibrosis, celiac disease, disaccharidase deficiency, acrodermatitis enteropathica, secretory neoplasms | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Systemic diseases | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Immunodeficiency, endocrinopathy (hyperthyroidism, hypoparathyroidism, congenital adrenal hyperplasia) | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Miscellaneous | |||
|- class="font12" style="font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | |||
| valign="top" bgcolor="#ffffff" class="font12" align="left" style="color: rgb(51, 51, 51); font-size: 12px; line-height: 17px; margin-top: 0px; margin-bottom: 9px; margin-left: 0px; margin-right: 0px; " | Antibiotic-associated diarrhea, secondary lactase deficiency, irritable colon syndrome, neonatal drug withdrawal, toxins, hemolytic uremic syndrome | |||
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<span class="Apple-style-span" style="font-size: 18px; font-weight: bold; ">Treatment</span> | |||
'''Diarrheal Pathogens in Children and Specific Therapy''' | '''Diarrheal Pathogens in Children and Specific Therapy''' | ||
{| border="1" cellpadding="2" | {| border="1" cellpadding="2" | ||
|- | |||
! align="left" | AGENT | ! align="left" | AGENT | ||
! align="left" | SPECIFIC THERAPY BEYOND SUPPORTIVE CARE | ! align="left" | SPECIFIC THERAPY BEYOND SUPPORTIVE CARE | ||
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| align="left" | ''Salmonella'' species | | align="left" | ''Salmonella'' species | ||
| align="left" | ''In toxic infants <3'' ''mo''<nowiki>:</nowiki><br />Ampicillin 200 mg/kg/24 hours q6h for 7–10 days ''and''<br />Gentamicin 5–7.5 mg/kg/24 hours q8h IV | | align="left" | ''In toxic infants <3'' ''mo''<nowiki>:</nowiki><br/>Ampicillin 200 mg/kg/24 hours q6h for 7–10 days ''and''<br/>Gentamicin 5–7.5 mg/kg/24 hours q8h IV | ||
|- | |- | ||
| rowspan="2" align="left" | ''Shigella'' species | | rowspan="2" align="left" | ''Shigella'' species | ||
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==See Also== | == See Also == | ||
Peds: Dehydration | Peds: Dehydration | ||
==Sources== | == Sources == | ||
Rosen's | Rosen's | ||
[[Category:Peds]] | <br/>[[Category:Peds]] <br/>[[Category:ID]] <br/>[[Category:GI]] <br/><br/><br/><br/> | ||
[[Category:ID]] | |||
[[Category:GI]] |
Revision as of 22:09, 22 June 2011
Causes
Infection |
Viral: rotavirus, Norwalk virus, enteroviruses, astroviruses, adenoviruses, caliciviruses |
Bacterial: Salmonella, Shigella, Yersinia, Campylobacter, Escherichia coli, Aeromonas hydrophila, Vibrio species, Clostridium difficile, tuberculosis |
Parasitic: Giardia lamblia, Entamoeba histolytica, Cryptosporidia |
Dietary disturbances |
Overfeeding, food allergy, starvation stools |
Anatomic abnormalities |
Intussusception, Hirschsprung disease, partial obstruction, appendicitis, blind loop syndrome, intestinal lymphangiectasia, short bowel syndrome |
Inflammatory bowel disease |
Malabsorption or secretory diseases |
Cystic fibrosis, celiac disease, disaccharidase deficiency, acrodermatitis enteropathica, secretory neoplasms |
Systemic diseases |
Immunodeficiency, endocrinopathy (hyperthyroidism, hypoparathyroidism, congenital adrenal hyperplasia) |
Miscellaneous |
Antibiotic-associated diarrhea, secondary lactase deficiency, irritable colon syndrome, neonatal drug withdrawal, toxins, hemolytic uremic syndrome |
Treatment
Diarrheal Pathogens in Children and Specific Therapy
AGENT | SPECIFIC THERAPY BEYOND SUPPORTIVE CARE |
---|---|
Campylobacter jejuni | Azithromycin 12 mg/kg/day PO for 5 days or |
Erythromycin 30–50 mg/kg/day, divided, tid PO for 5–7 days | |
Clostridium difficile | Metronidazole 30 mg/kg/day, divided, qid PO for 7–10 days or |
Escherichia coli | Azithromycin 12 mg/kg/day PO for 5 days or |
Trimethoprim-sulfamethoxazole 10 mg (TMP)/kg/day PO divided bid for 5–7 days | |
Giardia lamblia | Metronidazole 15 mg/kg/day PO, divided, tid for 5 days |
Salmonella species | In toxic infants <3 mo: Ampicillin 200 mg/kg/24 hours q6h for 7–10 days and Gentamicin 5–7.5 mg/kg/24 hours q8h IV |
Shigella species | Azithromycin 12 mg/kg/day PO for 5 days or |
Trimethoprim-sulfamethoxazole 10 mg (TMP)/kg/day, divided, bid for 5–7 days if susceptible | |
Yersinia enterocolitica | If patient is immunosuppressed, treat as for presumed sepsis |
Vibrio | None; severe diarrhea or cholera may benefit from antibiotics |
See Also
Peds: Dehydration
Sources
Rosen's