Back in 1985, the pediatrician Theodor Escherich from Austria, working on the study of intestinal microflora, discovered a new variety of bacteria - E. coli. Somewhat later (1894) Georgy Gabrichevsky was able to personally verify that this microorganism is actively involved in the development of diarrhea. Thus, he confirmed Escherich's theory regarding the etiological role of this bacterium. We can say that from that very moment the history of the group of intestinal infections under the general name Escherichiosis began. In children, they are quite common.
Pathogen
Who exactly discovered the disease with such a marvelous name? Under this term (as in the case of other infections), the name of the pathogen is hidden. It's about the bacteria Escherichia. Its main representative is E. coli.
Today there are a huge number of varieties of this microorganism. Moreover, all of them can be divided into two biological species, depending on toxigenic qualities:
- opportunistic bacteria;
- diarrheagenic microorganisms.
From a morphological point of view, Escherichia is a rod in which both ends are rounded. These microorganisms feel good in an environment with a pH of 7.2-7.4 and a temperature of 37 ° C. In addition, bacteria have qualities that can almost be envied. They are not affected by environmental factors, however, bacteria are sensitive to disinfectants, and when boiled they quickly die.
ICD-10 code for Escherichiosis in children
The term Escherichiosis should not be understood as a single disease, but a whole group of diseases, usually of an acute infectious nature. Mostly they develop in young children (up to 3 years). Moreover, the main feature of exposure to Escherichia bacteria is that they are able to penetrate the colon epithelial cells.
In other words, the pathological process is mainly localized in the gastrointestinal tract. This entails the development of an infectious toxic and diarrheal syndrome. In rare cases, there may be damage to other organs, including the development of sepsis.
According to the international classification of diseases, the ICD-10 code for escherichiosis in children is A04. However, this is a common cipher. Depending on the prevalence of the pathogenic factor, 5 groups of infections caused by the pathogen Escherichia coli are distinguished:
- A04.0 - enteropathogenic.
- A04.1 - enterotoxigenic.
- A04.2 - enteroinvasive.
- A04.3 - enterohemorrhagic.
- A04.4 - other options.
The best atmosphere that allows bacteria to multiply actively is any medium. How does their presence in a child's body manifest itself?
Manifestation of exposure to Escherichia
Escherichiosis is distinguished by the fact that it starts in an acute form. Only in rare cases, the infection develops gradually. The incubation period of E. coli does not last long, from 2 to 24 hours. However, it can stretch for five days.
As in the case of any other disease, there are also three degrees of manifestation:
Moreover, each of them is characterized by individual features.
Easy stage
Symptoms of Escherichiosis in mild children are mild. Body temperature rises slightly, and may even remain within normal limits. Patients usually complain of a state of general weakness. Their appetite decreases, and malaise appears. Children may experience moderate aching abdominal pain.
The consistency of the stool is usually liquid or porridge. Regarding regularity, it can be up to 5 times a day.
Moderate severity
Here the symptoms begin to intensify. Body temperature rises sharply up to 39 ° C. Other signs may also be observed:
- chills;
- weakness;
- migraine;
- unpleasant cramping sensations;
- tingling in the intestines.
The main feature of the disease of moderate severity can be considered the impulse pain experienced by the child. Moreover, they are accompanied by abundant stools, liquid and quite frequent. Its consistency is watery, odorless.
As a rule, in the case of Escherichiosis in children, clinical manifestations may be accompanied by a feeling of nausea and vomiting. Breasts often spit up. The watery consistency of feces can be supplemented with foam, as well as an orange or yellowish shade with a splash of green.
As for the regularity of the stool, then in this case it is even more common (up to 10 times a day).
Heavy form
This stage of the disease is quite rare. Its distinguishing feature is the pronounced signs of intoxication. In this case, the body temperature can rise up to 40 ° C. The regularity of the stool is from 10 times a day. Signs of dehydration are added to the main symptoms of Escherichiosis. This threatens the development of toxicosis with exsicosis.
Palpation of the abdomen causes pain. In addition, one can detect rumbling, flatulence (bloating), a pale shade of the skin. An accurate diagnosis is made only after a laboratory test.
Development reasons
Diagnosis and treatment of Escherichiosis in children largely depends on the cause of the disease. The main way of infecting children with Escherichia coli is through the contact-food method, from the mother or medical staff. In addition, another sick child may act as a source of infection, especially during an acute course.
The risk group includes those children who are fed artificially. E. coli can enter the young body through a mixture or through dishes that have undergone poor sanitization.
In addition, you can not discount the endogenous way of developing the disease. This is largely facilitated by the spread of EPA to the upper intestinal tract. To a greater extent, the situation is relevant for children with dysbiosis and immunocompromised. Escherichiosis is also unique in that various types of bacteria infect children of different ages.
Also, the cause of the development of Escherichiosis in children can be the climate. In countries with hot climates, the probability of infection with E. coli is several times higher.
Another important factor is living conditions. In other words, everything may depend on the improvement of the home. This also includes the nature of the provision of the population with water and food.
Diagnostic measures
Escherichiosis by its nature has the same symptoms as some other diseases:
- salmonellosis;
- cholera;
- shigellosis;
- viral gastroenteritis;
- food poisoning.
In other words, nonspecific clinical signs are clearly observed here. For this reason, to establish an accurate diagnosis, a gastroenterologist will need a whole range of diagnostic studies. In another way, it is impossible to determine the treatment regimen for Escherichiosis in children of 6 months or older patients.
First of all, the following procedures are needed:
- Familiarization of the doctor with the patient’s medical history.
- The formation of a general history that will establish the path of infection with a pathogenic bacterium.
- A thorough examination of the patient: palpation, percussion of the anterior wall, measurement of blood tone and temperature.
- A detailed survey of the parents of a sick child regarding the regularity of the stool and the severity of symptoms.
In addition, for the diagnosis of Escherichiosis in children can not do without laboratory tests:
- Bacterial culture (feces, vomit, urine, blood, other biological fluids) to identify the type of bacteria. In addition, this study allows you to determine the degree of sensitivity to antibacterial agents.
- Serological tests help detect antibodies in the patient’s blood.
- General urine analysis.
- A polymerase chain reaction or PCR diagnosis is needed to differentiate a bacteriophage or a strain of E. coli.
- The study of feces for the presence of dysbiosis. In this case, you can establish an accurate diagnosis when the disease has hidden symptoms.
When determining the diagnosis in adult patients and children, instrumental diagnostics are not performed due to the fact that it does not make sense.
Treatment of Escherichiosis in children
Since infection with Escherichia coli is usually referred to as acute intestinal infections, the course of treatment is based on the same measures that are applicable to similar diseases. An integrated approach is important here. Therapy is compiled by the attending physician taking into account the severity of the disease, the period of the disease, the age of the patient.
As a rule, treatment of the disease is outpatient, but there are exceptions. Mandatory hospitalization is indicated in the following situations:
- Newborns and children up to a year with any type of E. coli infection.
- Young patients up to two years of age with moderate or severe disease.
- Those children who attend closed institutions.
With this disease, all small patients, without exception, are supposed to rest in bed during the acute period. From the point of view of pediatrics, Escherichiosis in children is treated conservatively, which includes effective methods:
- Maintaining a sparing diet: during an acute manifestation, diet No. 4 is shown, and after the symptoms subside, diet No. 13 is shown.
- With escherichiosis, heavy drinking is indicated.
- Reception of oral rehydration mixtures; with severe signs of dehydration, injection is indicated.
- Reception of antibacterial drugs is carried out in courses and no more than 10 days.
- Probiotics, enterosorbents, enzyme substances and eubiotics - the use of all this helps to normalize digestion and restore intestinal microflora.
It is not advisable to carry out surgical intervention with such a bacterial infection. However, the same applies to traditional medicine.
Possible complications
In most cases, the treatment of Escherichiosis is effective, that is, there are usually no complications, but this refers to mild to moderate infection.
Some consequences may occur. In particular, we are talking about the following side effects of escherichiosis in children:
- acute renal failure;
- infectious toxic or hypovolemic shock;
- sepsis;
- encephalitis;
- meningoencephalitis (a complication after encephalitis or meningitis);
- pneumonia;
- pyelonephritis;
- pyelocystitis;
- cholecystitis;
- cholangitis;
- thrombocytopenic purpura.
Fatal outcome is possible only in relation to newborns and only with a mixed infection.
Preventive actions
Since intestinal infection can be transmitted in a variety of ways, it is necessary to adhere to certain preventive tactics:
- Do not neglect the rules of personal hygiene.
- Avoid all contact with an infected person.
- Always wash fruits and vegetables before eating.
- Dairy products of dubious origin, as well as meat that has not undergone proper heat treatment, must be discarded.
- Refuse to drink tap water.
- With outbreaks of infection in children's groups, quarantine is necessary.
The importance of clinical recommendations from Escherichiosis in children should not be underestimated. Preventive measures include regular passing a full examination with the participation of all the necessary doctors.
In general, the forecast is rather favorable. However, this applies only to those cases when the appearance of characteristic signs is not ignored, and diagnosis is carried out in a timely manner. Refusal of qualified medical care in any case can lead to complications. They can be serious, and in some cases, death can not be avoided.