Child Health  |  Gastroenteritis Pathway - Blood Diarrhoea




Child Health

Gastroenteritis Pathway - Blood Diarrhoea

Is there bloody diarrhoea?

If there is blood or mucous in the stools, abdominal pain or systemic toxicity consider the diagnosis of bacillary dysentery, and discuss with paediatrician.

If the child is not immunocompromised or systematically unwell, you can afford to wait until culture results and specific sensitivities are available. In this situation, antibiotic therapy is almost never indicated.

Organism    Possible complications Antibiotic therapy
Campylobacter Neonatal septicaemia convulsions, Guillain-Barre syndrome, Reiter’s syndrome. May mimic appendicitis
  • In uncomplicated gastroenteririts, some benefit of therapy if givenearly. Usually the diagnosis is made too late for useful therapy (Erythromycin PO for 5 – 7 days)
  • Bacteremia is rare. Discuss with senior

Entero-invasive

Escherichia coli

 
  • Cotrimoxazole or Amoxil PO may be of use

Salmonella

(non-typhoid)

Bacteraemia, meningitis, osteomyelitis, typhoid fever
  • Not indicated in uncomplicated gastroenteritis (may prolong duration of excretion of orgasnism)
  • In bacteraemic infants < 3 months, or children with complications, IV Ceftriaxone.
  • Duration of therapy is 14 days, or up to 6 weeks for meningitis or focal sepsis
Shigella Bacteraemia, colonic perforation, convulsions, haemolytic-uraemic syndrome, Reiter’s syndrome, fulminant toxic encephalopathy
  • In bacteraemic infants < 3 months, or children with complications, IV Ceftriaxone (there are other options, discuss with senior)
  • In some cases treatment may be required for mild disease for reasons of public health. In this case, choose antibiotic by sensitivities
Yersinia Bacteraemia, conjunctivitis, glomerulonrphritis, hepatic or splenic abscess, meningitis, osteomyelitis, pharyngitis, osteomyelitis, pharyngtis pneumonia, reactive arthritis, pseudoappendicitis
  • No evidence for antibacterial use in a sick child, discuss with paediatrican.

 

 



Last updated : Thursday, May 18, 2017
Next review date : Friday, May 18,2018


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