Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
권호 표지

Acute infectious Diarrhea in Pediatirc Patients

소아의 급성 감염성 설사

  • 마상혁 (창원 파티마병원 소아과)
  • Received : 2005.02.12
  • Accepted : 2005.02.16
  • Published : 2005.03.15
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Abstract

Acute diarrhea is one of the most common diseases that are seen in pediatric patients. In the management of acute diarrhea, several differential diagnostic criteria should be considered based on clinical and/or laboratory findings. These criteria include : (1) normal variant stool versus diarrhea (2) infectious versus non-infectious condition and (3) bacterial versus non-bacterial etiology. The use of antibiotics should be considered to manage diarrhea caused by bacteria accompanying fever and bloody diarrhea in the following cases : (1) patients with serious clinical course, (2) under three months, (3) immunocompromised patients, (4) patients with nutritional deficiency and (5) patients presenting with moderate-to-severe dehydration. In patients presenting with the symptoms suspected to be bacterial origin, whose clinical course is not serious, antibiotic therapy is not necessary. These patients are easily manageable at OPD level. Moreover, except for some cases in which the use of antibiotics is inevitable, pediatric diarrhea can be managed by providing the suitable foods alone with no necessity of other specific drugs. Accordingly, it is crucial not so much to depend on the drugs as to provide appropriate foods including oral rehydration solution(ORS) with no further episodes of diarrhea. Special attention should be paid to the fact that younger pediatric patients will undergo nutritional deficiency unless acute diarrhea is properly managed.

Keywords

References

  1. Whang JB. Basic principles and clinical assesment of diarrhea in children. Jungwae Press 1999:11-99
  2. Goodgame RW. Viral causes of diarrhea. Gastroenterol Clin North Am 2001;30:779-95 https://doi.org/10.1016/S0889-8553(05)70210-7
  3. Turgeon DK, Fritsche TR. Laboratory approaches to infectious diarrhea. Gastroenterol Clin North Am 2001;30:693-707 https://doi.org/10.1016/S0889-8553(05)70206-5
  4. Ramaswamy K, Jacobson K. Infectious diarrhea in children. Gastroenterol Clin North Am 2001;30:611-24 https://doi.org/10.1016/S0889-8553(05)70201-6
  5. Abe T, Kobayashi M, Araki K, Kodama H, Fujita Y, Shinozaki T, Ushijima H. Infantile convulsions with mild gastroenteritis. Brain Dev 2000;22:301-6 https://doi.org/10.1016/S0387-7604(00)00111-X
  6. Parashar UD, Bresee JS, Gentsch JR, Glass RI. Rotavirus. Emerging Infectious Disease 1998;4:561-70 https://doi.org/10.3201/eid0404.980406
  7. Mitchell DK. Astrovirus gastroenteritis. Pediatr Infect Dis J 2002;21:1067-69 https://doi.org/10.1097/00006454-200211000-00018
  8. Jiang X, pickering LK. Update on caliciviruses and human acute gastroenteritis. Pediatr Infect Dis J 2002;21:1069-70 https://doi.org/10.1097/00006454-200211000-00019
  9. Lopman BA, Brown DW, Koopmans M. Human caliciviruses in Europe. J Clin Virol 2002;24:137-60 https://doi.org/10.1016/S1386-6532(01)00243-8
  10. Armon K, Stephenson T, MacFaul R, Eccleston P, Werneke U. An evidence and consensus based guideline for acute diarrhoea management. Arch Dis Child 2001;85:132-42 https://doi.org/10.1136/adc.85.2.132
  11. Gentsch JR, Woods PA, Ramachandran M, Das BK, Leite JP, Alfieri A, et al. Review of G and P typing results from a global collection of rotavirus strains : implications for vaccine development. J Infect Dis 1996;174(Suppl 1):S30-6
  12. Gastanaduy AS, Begue RE. Acute gastroenteritis. Clin Pediatr 1999;38:1-12. https://doi.org/10.1177/000992289903800101
  13. Chiba S, Estes MK, Nakata S, Calisher CH. Viral gastroenteritis. New York, Springer-Verlag Wien; 1996, p1-99
  14. Oh SH. Diagnosis and treatment of infectious gastroenteritis. Korean J Pediatr 2003;46(3 Suppl):S26-35
  15. Korea Center for Diease Control and Prevention. Estimation of disease control and prevention in 2004