Childhood enteritis caused by E. coli

　　Childhood enteritis caused by E. coli is most commonly caused by bacteria and viruses. A few cases of enteritis have unknown etiology. The causative bacteria of bacterial enteritis are most commonly Shigella, followed by Campylobacter jejuni and Salmonella. In viral gastroenteritis, rotavirus is the main cause of infantile diarrhea, while Norovirus is the main cause of epidemic viral gastroenteritis in adults and older children. Entamoeba histolytica is the most common cause of amebic enteritis. Fungal enteritis is most often caused by Candida albicans. In addition, irregular rest and excessive mental stress are also one of the causes of this disease.

    In addition to its clinical manifestations, childhood enteritis caused by E. coli can also lead to other diseases. Hemorrhage is the most common local complication of childhood enteritis caused by E. coli, which should be highly emphasized by clinical doctors and patients.

　　Childhood enteritis caused by E. coli can be divided into enterotoxigenic E. coli enteritis, enteroinvasive E. coli enteritis, hemorrhagic E. coli enteritis, and adherent E. coli enteritis. The specific clinical manifestations are as follows:

　　1. Enterotoxigenic E. coli enteritis

　　The incubation period is 1-2 days, with a relatively acute onset. Clinical manifestations are similar to cholera, with generally no fever or low fever, diarrhea is mostly watery, with a large amount and a foul smell. Under microscopic examination, no white blood cells and red blood cells are found, and there is often moderate to severe isotonic or hypotonic dehydration. It is a self-limiting disease with a course of 4-7 days.

　　2. Enteroinvasive E. coli enteritis

　　The incubation period is 18-24 hours, with an acute onset, frequent diarrhea, sticky and jelly-like stools with pus and blood, often accompanied by nausea, vomiting, high fever, abdominal pain, and urgent need to defecate. Severe symptoms of poisoning and even shock may occur.

　　3. Hemorrhagic Escherichia coli enteritis

　　Increased frequency of stools, starting with yellow watery stools, then turning into bloody water stools, with a special smell, stool microscopy shows a large number of red blood cells, usually without white blood cells. Accompanied by abdominal pain, some cases may be accompanied by hemolytic uremic syndrome and thrombocytopenic purpura.

　　4. Adhesive Escherichia coli enteritis

　　Common in infants and young children, fever, diarrhea, and yellowish water-like stools.

　　The most important thing in the prevention of infant Escherichia coli enteritis is to avoid children from contacting the source of infection and pathogens. The main preventive measures include the following several:

　　1. Pay attention to household hygiene, install mosquito nets, kill flies and cockroaches, and keep the environment clean.

　　2. Avoid eating unclean raw and cold food.

　　3. Pay attention to the safety and cleanliness of the infant's utensils.

　　4. Isolate patients and handle their excreta carefully.

　　Clinically, most lesions of infant Escherichia coli enteritis are located in the rectum and sigmoid colon, and sigmoidoscopy is very valuable. For patients with chronic or suspected total colon, fiberoptic colonoscopy is recommended. Barium enema is also an important clinical method for examining infant Escherichia coli enteritis, but it is generally not recommended to perform barium enema during the acute stage. Special attention should be paid to the possibility of induced intestinal dilatation and perforation in patients with severe ulcerative colitis during barium enema.

　　The dietary principles for infants with Escherichia coli enteritis are to avoid stimulation, neither too cold nor too hot.

　　1. Avoid smoking, alcohol, and spicy刺激性 food.

　　2. Avoid irregular diet.

　　3. Avoid very cold, hot, and hard food: such as, cold and hot food and beverages.

　　4. Abstain from刺激性 food: such as chili, mustard, pepper, strong tea, coffee, cocoa, and other food or beverages.

　　The basic treatment guidelines for infant Escherichia coli enteritis are fluid replacement and symptomatic treatment, and appropriate antibiotics are given to improve clinical symptoms and shorten the shedding period. The basic treatment principles include the following three:

　　1. Pathogen treatment.

　　2. Supplement fluids and correct electrolyte and acidosis.

　　3. Reduce intestinal peristalsis and secretory drugs.