Clinical and Bacteriological Studies in Childhood Shigellosis: especially Effect of Rifampin in Shigellosis

Clinical and bacteriological studies were made on 168 cases of culture proved childhood shigellosis at Wallace Memorial Baptist Hospital in Busan between Aug. 1978 and July 1980. The following results were obtained. 1. Of 168 cases, 99 cases were male and 69 were female, the ratio being 1.4:1. The most frequently affected age group was between one three six years(57.7%) and the youngest was one month old infant(2 cases). 2. The peak incidence was in summer (34.5%), however it occurred throughout the year, even in winter(17.3%). 3. The most frequent symptoms on admission were diarrhea (86.9%), fever(77.4%), vomithing (36.9%), convulsion(38.7%) and abdominal pain(28.6%). 4. WBC count in peripheral blood was variable from leukocytosis to leukopenia and over 5% of band form was seen in 52.4%. 5. Sh. Flexneri was the most frequently isolated strain(86.3%) followed by Sh. Sonnei(6.5%), Sh. Boydii(4.8%) and Sh. Dysenteriae (2.4%). 6. The result of sensitivity test reveales that Oxolinic acid was the most sensitive drug(86.2%) followed by Gentamicin(83.9%) and Cefazolin(80.4%). It also revealed the high prevalence of resistance to Ampicillin(88.0%), Chloramphenicol(92.7%) and Tetracycline (95.6%). 7. 54 isolated shigellae strains were tested for Minimal Inhibitory Concentration in tube dilution method and inhibition zone diameter in single disc test (Rifampin disc 5g/ml). MIC were below 12.5g/ml in 77.7% and below 25g/ml in 90.7% and inhibition zone diameter was over 8mm in 88.7%. 8. Clinical response to antibiotic therapy revealed that clinical improvement was seen within 5 days of therapy in 48.1% of Ampicillin therapy group and 58.1% of Septrin therapy group and within 4 days of therapy in 95.7% of initial Rifampin therapy group and 97.2% of altrnative Rifampin therapy group. 9. Bacteriological response to antibiotic therapy revealed that within 4 days of Ampicillin and Septrin therapy the negative conversion rate was 49.1% and 54.4% respectively. The negative conversion within 3days of Rifampin therapy was observed in 93.4% of initial therapy group and 96.6% of alternative therapy group. 10. There was no untoward reaction of Rifampin during therapy except for the reddish discoloration of urine and stool.

One case of Instussusception in Schoenlein Henoch Vasculitis

Intussusception in Schoenlein-Henoch Vasculitis is of interest because of its rarity & the importance of making what may be a difficult diagnosis. We recently experienced one case of Intussusception in Schoenlein-Henoch Vasculitis, who was a 3 year-old girl treated with mannual reduction following surgical operation & we reviewed some literature.