ABSTRACT
Bloody diarrhea has been noticed to occur with increasing incidence In our locality. Detection of the causes will help in patient evaluation and proper treatment. The aim of this work was to elucidate the etiology of bloody diarrhea, the clinical and epidemiological profile and the use of third generation cephalosporin in the management of both acute and persistent diarrhea. The study involved 100 infants and children [74 males and 26 females] suffering from bloody diarrhea, aged 1-48 months and 20 apparently healthy controls of matching age and sex. Stool samples were investigated for infectious causes of diarrhea by culturing on appropriate media. All cases were subjected to complete clinical examination and blood picture. Eighty-five percent [85%] of cases were proved to have infectious bloody diarrhea, 6.1% of them were associated with Entameba histolytica. Non infectious cases were 5% allergic, 6% surgical and 4% bleeding tendency. Increased incidence of bloody diarrhea was found more in bottle and mixed fed children and in infants aged <1 year and in infants weaned before 6 months. Twenty cases had protein energy malnutrition [FEM], 67% were anemic and 63% had leukocytosis. stool culture revealed 41.1% E. coli [31 EHCH], 31.7% Salmonella, 14.1% Shigelia and 9% Campylobacter species. No single case of Clostridium difficiie was detected in our series. The frequency of improvement in cases who received 3rd generation cephalosporin [cefotaxime] was 97.5% versus 75% in cases who did not receive it. Campylobacter cases did not improve by the use of 3rd generation cephalosporin but improved by erythromycin
Conclusion: The problem of bloody diarrhea in our locality is mostly infectious mainly by E. coli and Salmonella species. Most of cases of bloody diarrhea improved on cephalosporin. However Campylobacter infection could be considered if the case did not respond to this type of treatment and the use of erythromycin is helpful in such cases. Prevention of infection is the most important challenge to avoid complication by encouraging breast feeding and considering vaccinations against the most prevalent organisms