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Abstract: The 11-month-old child had recently been having diarrhea for 1 week, with stools 6-8 times a day, jam-like in color, and with a fishy odor, and was found to have significantly higher white blood cells by stool tests, which was considered to be a bacterial infection with infantile diarrhea. After treatment with antibiotics and probiotics, the child’s symptoms gradually subsided.
Basic information】Male, 11 months old
Type of disease】Infant diarrhea
Hospital】Shanghai Sixth People’s Hospital
Date of Consultation】April 2021
Treatment plan】Medication (Cefaclor capsules + probiotics + montelukast + oral rehydration salts (III) + lactase)
【Treatment period】Reviewed in 7 days of home treatment
Treatment effect] The number of stools decreased significantly, and the nature improved
I. Initial consultation
An 11-month-old boy was brought to the hospital by his parents, who said that the child had repeatedly had diarrhea for 1 week, with fishy, jam-like stools. At first, he had diarrhea 3 times a day, but recently he had diarrhea 6-8 times a day, and his appetite was very poor and he was depressed. Further questioning of the medical history revealed that the child followed his parents to a restaurant before the onset of the disease, and the parents also gave a little bit of food to taste, followed by the above symptoms. The total amount of food eaten by the child in the last 2 days was only about 60% of the usual amount, and he had very little urine. On examination, there was no abnormality on cardiopulmonary auscultation, no abnormality on abdominal palpation, the limbs were still warm, and the skin was still elastic. Stool routine, stool adenovirus, rotavirus, norovirus culture, and stool bacterial culture were done. The results of stool routine showed a significant increase in leukocytes, with 26 leukocytes/HP under high magnification, so the diagnosis of bacterial infection of infantile diarrhea was made.
II. Treatment history
The child was prescribed oral antibiotics, such as cefaclor capsules, with the addition of oral probiotics to regulate the intestinal flora, as well as oral montelukast to stop the diarrhea. Oral rehydration salts (III) were also added to prevent dehydration and electrolyte disturbances because the child had a weak appetite and a low diet. Also, when stool specimens were taken, bacterial cultures of the stool were done so that there would not be more serious bacteria breeding in the intestine, which would lead to poor treatment. In addition, because many children with prolonged diarrhea develop secondary lactose intolerance, oral lactase treatment was added. We were advised to keep the diet and supplements as light and simple as possible during these days, and to focus on hydration.
Effect of treatment
After the child’s parents went home, they followed the doctor’s advice and gave the child a diet of water, milk, porridge, some simple mashed meat and vegetables, and kept the child hydrated every day, as well as regular and scheduled medication. The child came to the site for a review at 7 days of treatment. Now the child’s condition has improved significantly, and the number of stools has been reduced to 2 per day, and the nature of the stools has returned to normal. The number of stools has been reduced to 2 times a day, and the nature of the stool has also returned to normal. The stool routine was rechecked, and all indicators returned to normal.
IV. Notes
We are glad that the child’s symptoms have improved after treatment, but after discharge, we still suggest that parents should pay attention to the following issues.
1. Give the child more drinking water and hydration on a daily basis to adjust the child’s intestinal health.
2, avoid allowing the affected child to eat food eaten by adults too early and maintain a light diet to avoid recurrence of discomfort symptoms.
3.If there are uncomfortable symptoms, make sure to go to the hospital for medical examination and active treatment.
V. Personal insight
By understanding the situation of the child in this case, we can see that diarrhea during infancy is very common and can be caused by a variety of reasons. Among the various causes of diarrhea, there are many treatments in common, such as simplification of diet, hydration, oral probiotics, antidiarrheal drugs or oral lactase. The child’s mental status, vitality, and urine output need to be closely monitored, which are indicators to assess the presence of dehydration. If possible, the stool can also be sent to the hospital in time for examination and laboratory tests, so that both treatment and examination are not delayed.