Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Dysentery is an important cause of morbidity and mortality among children less than five years, it is caused by viral, bacterial, or protozoan infections or parasitic infestations. About 10% of all diarrheal episodes in children less than five years are dysenteric, but these causes about 15% of all deaths attributed to diarrhea are dysenteric.
OBJECTIVE:
To highlight the causes and clinical manifestations of bloody diarrhea in children younger than six years of age and to clarify the most important associated factors.
METHODS:
A prospective study was carried out on Children Welfare Teaching Hospital /Medical city/Baghdad, on 92 children who were admitted to the hospital with bloody diarrhea, their ages ranged between two months -6 years. The period of study is from (first of November 2013-30th of April 2014). A thorough history were carried out, general stool examination and stool culture were done by taking fresh stool samples collected from these children and underwent to serial investigations. Any patients who had received antibiotics during their illness were excluded from the study.
RESULT:
Ninety two patients their age ranged from second month of life till 6 years old that admitted to the children welfare teaching hospitals because of bloody diarrhea. The most common microorganism isolated was E .histolytica 59(64.13%) followed by Shigella spp.11 (11.96%).
It was found that male 51(55.43%) and female 41(44.57%), most of them live in urban 39(42.40%) or suburban 31(33.69%) area, most of them consume tap water 47(51.08%),more than half of them with mixed feeding 42(56.75%), the most common age group affected was the first two years 74(80.43%).
Regarding the clinical presentation it was found that in amoebic dysentery the most common finding was tenesmus 52(88.13%),followed by fever 35(59.32%), vomiting 19(32.20%),then convulsion4(6.77%), while in Shigellosis the most common finding was fever 9(81.81%), followed by tenesmus 8(72.72%),vomiting7(63.63%), then convulsion 4(36.36%).
CONCLUSION:
E. histolytica was the most common microorganism isolated in patients with bloody diarrhea and the most common age group affected was the first two years of life.
Mixed feeding in the first two years was associated with higher rate of infection
Consuming of boiled water associated with least incidence of bloody diarrhea and the most common presentation were tenesmus, fever, vomiting, and convulsion.