If intestinal infection: symptoms, treatment
The clinical picture of intestinal coli-infections in children and adults
If infection is acute intestinal disease. Another name for E. coli, coli-bacteriosis. Mainly occurs in children, rarely in adults. Pathology refers to food poisoning, the source of infection – a sick person, a carrier. The disease is transmitted contact-household way, in babies the infection can spread dust if inhaled.
Epidemiology if infection
The causative agent of intestinal infections – Escherichia coli. This rod-shaped gram-negative bacterium that is a parasite in anaerobic conditions. The microorganism belongs to the family Enterobacteriaceae.
The Escherichia are divided into four classes. In total there are more than 100 enterovirulent types, with morphological characteristics of all members are identical.
Escherichia coli the Escherichia resistant to environmental conditions. Retain their activity for a long time (up to 4 months) in water, soil, faeces. They are not affected by drying. Bacteria multiply rapidly in foods, particularly dairy. Wand easily adjusts to the natural changes and the new environment.
The organism dies quickly when disinfecting, boiling, temperatures above 60°C, exposed to direct sunlight.
The Escherichia-Koli belong to conditionally pathogenic microflora. They inhabit the small intestine the first days of life and do not exceed 1% of the total bacteria. Non-pathogenic serotypes contribute to the production of b vitamins, fatty acids, regulates the absorption of calcium and iron.
Enterotoxigenic motile coli attach to the cells lining the small intestine, multiply and produce toxins. In some cases, developing hemorrhagic colitis (bleeding in the epithelium).
The infection is transmitted through food, water, polluted air. The bulk of Escherichia coli-coli excreted in the feces, a small amount of urine. If a fixed event of illness, it is indicative of an infectious outbreak. Most often E. coli infects the intestine of the infants first year of life. Among the acute intestinal infections it is found in 30% of cases. Gradually, this percentage decreases. The older the child, the less it hurts if infection.
This high figure is due to the fact that newborns have no immunity to the disease, but during fetal development it is not transmitted from mother to child. If the mother has antibodies to the bacteria through breast milk when feeding can form a passive immunity, especially in infants 3-5 months.
Structural changes in the intestine in Koli infection:
- the presence of inflammatory lesions;
- redness of the mucous membrane;
- degenerative processes leading to destruction of the epithelium;
- swelling, narrowing of the lumen of the intestine;
- functional disorders in the submucosal layer – a failure of exchange processes, microcirculation;
- rarely diffuse morphological changes.
The average incubation period lasts from days to 4-5 days. Patients of different ages Escherichia coli-infection develops differently. The main symptom is diarrhea of varying intensity.
In adults E. coli begins suddenly, sharply. The first signs:
- the increase in body temperature to 38°C;
- nausea, urge to vomit;
- diarrhea 10 to 15 times a day;
- deterioration of the General condition;
- cramping pain before defecation.
Diarrhea if infection is watery, the color yellow, Golden, orange, sometimes with a green tint. Vomiting is rare, but it is resistant, not bringing relief and worsen the health of the patient.
In breastfed babies infection develops gradually with the increase. Its peak on the 5th day after the first signs:
- body temperature does not exceed 37.5°C;
- regurgitation after feeding;
- frequent diarrhea;
Stool with admixtures of undigested food, glassy transparent mucus, rarely with blood. Gradually, through the allocation of water in the lumen of the intestine, the stool becomes more liquid, watery. Have kids act of defecation in the form of heavy jets.
The child is restless, sleeps badly, refuses to accept formula or breast milk. Belly swollen, painful because of the increased gas formation and putrefaction in the intestines. Rapidly evolving dehydration. Its symptoms:
- mild – vomiting 1-2 times a day, stool 3-6 times a day;
- form of medium gravity chair up to 12 times a day, vomiting persistent, repeated, body temperature 38-39°C, is developing a potassium deficiency, which appears on the heart;
- a severe form of fever to 40°C, the frequency of acts of defecation 20 per day, the loss of salts and water rapid, if it is 10% of the weight of the child, develops hypovolemic shock (paralysis of the intestine, insufficiency of the myocardium).
Hard intestinal infection occurs in young patients under the age of 6 months. Included in the risk group of underweight and premature infants. They have simultaneously developing pathology of the immune system, join secondary infectious diseases – meningitis, pyelonephritis, otitis media.
In children with year to 3 years of coli-bacteriosis occurs with clinic gastroenteritis is an acute inflammation of the mucosa of the small intestine. In the infectious-inflammatory process rarely involves the large intestine.
Stool at the child liquid without impurities and inclusions. The overall status depends on how quickly dehydrated.
Children up to 3 years E. coli can be triggered by respiratory infections or measles. The duration of illness 7-14 days.
The child of 3 years old intestinal infection is manifested by such signs:
- moderate stomach and intestinal pain;
- without vomiting;
- stool copious;
- the temperature is normal or slightly increased for the first three days;
- the duration of illness 4 to 7 days.
Diagnoses if infection
Final diagnosis number of ipekli is approved only on the basis of bacteriological examination. As biomaterial used to take fecal and vomit, the washings of the stomach, blood and food remains. Newborns to bacterial culture test take the mucus from the nasopharynx. After taking the material he was immediately inoculated into special nutrient media and rapidly transported to the laboratory. If this is not possible, make conservation with the use of mixtures (preservatives).
The drawback of this method is the duration of the study. The average result is ready in 2-4 days, sometimes later. Stored material can not be at room temperature. In these conditions multiplies saprophytic microflora (and related), which causes the decomposition of Escherichia coli Coley and her death.
To identify bacteria use serologicheskie methods by defining specific antigens. Determine the number of pathogenic cells per 1 g of faeces.
When ELISA (enzyme-linked immunosorbent assay) detect the ability of bacteria to produce toxins.
Differential diagnosis is complicated. It is important to exclude these diseases:
Treatment intestinal infection if
Toddlers to 3 years with suspected if infection hospitalitynet. Preschoolers and adults can receive therapy at home.
Treatment if infection in children aimed at eliminating dehydration. If the minor signs, administered oral rehydration solution (oral) liquid containing salts necessary for the normal functioning of the body:
Babies immediately administered saline solutions, parenteral (intravenous):
In patients with exericise very pronounced thirst. Despite this, it is impossible that the fluid in the body acted quickly and in large quantities. Solutions need to type at a speed of not more than 1 liter per hour. This will ensure full absorption of the drug and eliminate the risk of vomiting.
If the child was admitted with acute poisoning food, they give him gastric lavage with a weak solution of potassium permanganate or baking soda. Procedure is done before the advent of clean wash water.
To eliminate the signs of gastroenteritis (diarrhea) is prescribed chelators:
For the relief of pain in the epigastric region and in the abdomen is prescribed antispasmodics – Nospanum, Spazmalgon. Also, in order to reduce inflammation and pain symptom shows non-steroidal anti-inflammatory drugs – Diclofenac, Nimesil, Indomethacin.
Antibiotic therapy prescribed in the following cases:
- severe forms of infection;
- the presence of complications;
- the content of the blood in the stool;
- elderly or infant age;
- the weakened immune system of the patient.
The most active regarding antibiotics if infection:
Part of a comprehensive treatment include vitamins and probiotics (live micro-flora).
Important in therapy if infection is a therapeutic diet. In the acute stage patients are prescribed the table No. 4 – light diet, which aims to eliminate putrefaction in the intestines. The principle of supply – reducing the amount of sugar, salt, fats and carbohydrates. The exception of any food which might irritate – the sharp, sour, fried, hard, cold and hot.
With the improvement of the condition of the patient is transferred to the dietary table 2. The principle of obtaining adequate nutrition, stimulation of the secretory function of the gastrointestinal tract. The dish must be chopped. Products can be boiled, baked, broiled, fried without a crust.
The outcome of the disease depends on several factors: the severity of the infection and the patient’s age, presence of complication and appropriate treatment. In General, the prognosis is favorable. The danger may be the accession of meningitis or sepsis. In infants with severe gastroenteritis syndrome can form a lack of enzymes the gastrointestinal tract.
Prevention of Escherichia coli-infection is breastfeeding, compliance with sanitary norms and requirements in kindergartens and maternity hospitals, in the factories and plants that produce food, personal hygiene at home.