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Abstract: A 5-year-old child presented to the hospital with recurrent fever for 5 days with a temperature of 37.8°C, occasional periumbilical pain that could be relieved, and recent progressive worsening of frequent loose stools for 2 days. The child’s parents reported that the child had frequent diarrhea for the past 2 days, with yellow, thin, paste-like soft stools 10 times/day. He was admitted to the hospital with abnormal blood and stool tests, and the stool culture was confirmed to be Salmonella infection.
Basic information】Male, 5 years old
Disease Type】Salmonella infection
Hospital】The Ninety-eighth Hospital of the People’s Liberation Army Joint Security Force
Date of consultation】May 2022
Treatment plan】Medication (cefazoxime sodium for injection + paramivir sodium chloride injection + piperacillin sodium sulbactam sodium for injection + potassium chloride injection + 0.9% sodium chloride injection + vitamin C injection + vitamin B6 injection + compound safranin tablets)
[Treatment cycle] Hospitalization for 7 days, review after 2 weeks
Treatment effect】The disease was controlled, the symptoms disappeared, and the indicators were normal.
I. Initial consultation
The 5-year-old child was a full-term newborn, born at term, breastfed, with no adverse dietary records, and no adverse lifestyle habits of his companions or family members. The child was first seen in the ward, where he had just cried and had recurrent diarrhea. The parents said that the child had fever 5 days ago with a temperature of 37.8℃ and occasional pain around the umbilicus, which could be relieved. In the past 2 days, he had frequent diarrhea, yellow loose stools, paste-like soft stools, 10 times/day. According to the child’s condition, the presence of intestinal infection was still considered, and further stool culture was performed for Salmonella infection, while other tests were not significantly abnormal.
II. Treatment
The child was given ceftizoxime sodium for injection as an anti-infection, and paramivir sodium chloride injection as an antiviral treatment for suspected influenza virus infection, and further stool tests were performed for routine white blood cells (++); red blood cells (+++), and stool culture: some species of Salmonella. According to the drug allergy, piperacillin sodium sulbactam sodium for injection was selected as anti-infection, and potassium chloride injection and 0.9% sodium chloride injection were given to maintain electrolyte balance, vitamin C injection and vitamin B6 injection were given to supplement vitamins, and compound Huangliansu tablets were given to supplement the anti-infection treatment. The fever gradually returned to normal, the discomfort disappeared, the diarrhea was relieved, the stool gradually became normal, the child’s appetite gradually increased, and the routine blood and stool tests returned to normal. Parents were instructed to take good care of the child and to eat a light and easily digestible liquid food or semi-liquid food. The child was instructed to pay attention to rest, take medication on time, strengthen intestinal nutrition, enhance the body’s resistance to disease, and avoid raw, cold and indigestible food.
III. Treatment effect
After 7 days of treatment, the child had no fever and no discomfort, his stool became normal, his diet returned to normal, and he regained his lively and active nature. The results of blood routine, stool routine and stool culture were normal, and the child’s mental and physical strength returned to normal, so he was discharged. The child was followed up for 2 weeks. The general condition of the child was good, and the family and accompanying persons were very concerned about personal, drinking and eating hygiene, and the child did not develop similar conditions again. The parents of the child were instructed to actively seek medical consultation in case of similar conditions to avoid delaying the condition.
IV. Notes
We are glad that the child’s symptoms have improved after treatment, but we still need to pay attention to the following conditions to prevent recurrence and reinfection.
1. Pay attention to dietary hygiene: do not drink raw water and do not eat meat from sick or dead animals and poultry.
2, meat and milk must be cooked and sterilized by autoclaving before importation.
3, food storage places need to eliminate flies, cockroaches, rats, to ensure the hygiene of drinking water, food.
4.If others are found to have similar symptoms, they should be well isolated.
5, do a good job of disinfection of the ward and room of the child.
6, pay attention to their own discomfort symptoms, if fever, diarrhea and other discomfort symptoms, promptly seek medical attention.
V. Personal insight
Through understanding the situation of the child in the case, Salmonella belongs to the Salmonella family of Enterobacteriaceae as a Gram-negative bacillus, mainly through fecal-oral transmission, but also through the contaminated meat, eggs, water transmission. The disease can occur throughout the year, and is more common in summer and autumn, with rapid onset, short incubation period, common in groups, and can recur. The main symptoms are sudden chills and fever, nausea, vomiting, abdominal pain, diarrhea, watery stools, and severe water-electrolytic disorders and severe dehydration. This disease is relatively rare in adults and common in children. If you do a good job of personal hygiene and hygienic treatment of drinking water and diet, this disease can be prevented and controlled, so even if you are infected, you do not need to be overly nervous.