Diarrhea (peds): Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "2 mg" to "2mg") |
Neil.m.young (talk | contribs) (Text replacement - "5 mg" to "5mg") |
||
Line 88: | Line 88: | ||
|- | |- | ||
| align="left" | ''[[Giardia]]'' lamblia | | align="left" | ''[[Giardia]]'' lamblia | ||
| align="left" | [[Metronidazole]] | | align="left" | [[Metronidazole]] 15mg/kg/day PO, divided, tid for 5 days | ||
|- | |- | ||
| 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. | | align="left" | ''In toxic infants <3'' ''mo''<nowiki>:</nowiki><br>Ampicillin 200 mg/kg/24 hours q6h for 7–10 days ''and''<br>Gentamicin 5–7.5mg/kg/24 hours q8h IV | ||
|- | |- | ||
| align="left" rowspan="2" | ''Shigella'' species | | align="left" rowspan="2" | ''Shigella'' species |
Revision as of 10:46, 19 July 2016
Background
Clinical Features
Differential Diagnosis
Infection
- Viral
- Rotavirus
- Norwalk virus
- Enteroviruses
- Adenoviruses
- Bacterial
- Parasitic
Dietary disturbances
- Overfeeding
- Food allergy
- Starvation stools
Anatomic abnormalities
- Intussusception
- Hirschsprung disease
- Partial obstruction
- Appendicitis
- Blind loop syndrome
- Intestinal lymphangiectasia
- Short bowel syndrome
Malabsorption or secretory diseases
- Cystic fibrosis
- Celiac disease
- Disaccharidase deficiency
- Secretory neoplasms
Systemic diseases
- Immunodeficiency
- Endocrinopathy
- Hyperthyroidism
- Hypoparathyroidism
- Congenital adrenal hyperplasia
Miscellaneous
- Inflammatory bowel disease
- Antibiotic-associated diarrhea
- Secondary lactase deficiency
- Irritable colon syndrome
- Neonatal drug withdrawal
- Toxins
- Hemolytic uremic syndrome
Diagnosis
Treatment
General Treatment
- If bloody diarrhea, use caution with beginning antibioitics in ED before stool culture results
- Some studies demonstrate antibiotic treatment in setting of E.coli O157:H7 leads to increasing risk of hemolytic uremic syndrome (HUS)
Diarrheal Pathogens in Children and Specific Therapy
AGENT | SPECIFIC THERAPY BEYOND SUPPORTIVE CARE |
---|---|
Campylobacter jejuni | Azithromycin 12mg/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 12mg/kg/day PO for 5 days or |
Trimethoprim-sulfamethoxazole 10 mg (TMP)/kg/day PO divided bid for 5–7 days | |
Giardia lamblia | Metronidazole 15mg/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 5–7.5mg/kg/24 hours q8h IV |
Shigella species | Azithromycin 12mg/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 cholera | None; severe diarrhea or cholera may benefit from antibiotics |