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InfantileDiarrhea
InfantileDiarrhea
腹泻病英文-医学课件outlinePrevalenceDefinitionPredisposingfactorsEtiologyPathogenesisManifestationsDiagnosis DifferentialdiagnosisTreatmentPrognosisPreventionrotavirusdiarrheaenterotoxigenicE.coli(ETEC)invasivebacterialenteritisfungusoutlinePrevalencerotavirusdia腹泻病英文-医学课件Question:What’skindofstoolisnormal?stoolQuestion:What’skindofstoolDefinition——isasyndromewithincreasedstoolfrequencyandchangesofcharacterofstoolwhichcausedbypathogensinfectionorotherreasons.Waterystoolwith/withoutmucous,bloodystoolFrequency≥3timesaday,Stoolvolume>10g/kg.dThemainreasoncausemalnutritionandgrowthretardation
Definition——isasyndromewithPredisposingfactorsImmaturedigestivefunctionGastricacidityDigestiveenzymesRapidgrowthPoorimmunefunction(hostdefenses)ImmunoglobulinsDisturbedentericbacterialfloraFormulafeeding
PredisposingfactorsImmaturedEtiology
infection
diarrhea
non-infection
IntestinalextraintestinaldietallergyweatherEtiologyinfec
InfectiousfactorsVirus(70%)RotavirusAdenovirusAstrovirus,NorwalkvirusCalicivirusNorovirusEnterovirusBacteriaEnteropathogenicE.coliCampylobacterjejuniShigellaSalmonellaStaphylococcus
aureusClostridiumdifficileFungi
CandidaalbicansParasiteInfectiousfactorsViruDevelopedcountryDevelopingcountryDevelopedcountryDevelopin
NoninfectiousfactorsDietWeatherColdHotImproperdietAllergyLactasedeficiencyNoninfectiousfactorsDietPathogenesisOsmoticdiarrheaSecretorydiarrheaExudativediarrheaAbormalmotility
notone,buttogetherPathogenesisOsmoticdiarrheaIntestinalvillicryptepitheliumIntestinalvillicryptepithelivirusenteritis
virusduplicate
mucosalinjury，villidamagedisaccharidaseactivitycarrierglucose,fatabsorption
osmoticpressurewaterydiarrhea
InfectionvirusenteritisInfectionBacterialenteritis
ETECenterotoxinheatlabiletoxinheatstabletoxinACGCATPcAMPGTPcGMPinhibitNa+,Cl-andwaterabsorbtion，promotesecreteCl-Na+,Cl-andwaterinceasedmorethancolonicabsorptionlimitwaterydiarrhea
BacterialenteritisNoninfection
overeatingfoodgatherinUGIPHbacteriamoveandreproduceendogenousinfection
fermentorganicacid(lactose,acetic-acid)amineliverdetoxificationfunctioninsufficiencyosmotictoxinenterintobloodbowelmovementtoxicitysymptomdiarrhea,dehydration,electrolytedisturbances,acidosisNoninfectionManifestationsClinicaltypesActuediarrhea:<2wPersistantdiarrhea:2w-2mChronicdiarrhea:>2mManifestationsClinicaltypesAcutediarrheaAcutediarrheaCommonclinicalmanifestations
Mild：Mainlycausedbydietaryfactorsorextraintestinalinfections.Waterystoolwithsour,foam,milkvalve,nopusorblood.Withoutdehydrationandtoxicitysymptom.Mostofthemrecoverinafewdays.Commonclinicalmanifestationssevere：Causedbyintestinalinfections>10/dwithmucus,pus,bloodStooltest:WBC+,RBC+GIsymptoms:vomit,anorexia,abdominalpain,distentionSystemicsymptoms:toxicity,shock,comaModerate,severedehydrationMetabolismacidosisElectrolytedisturbances：hypokalemia,hypocalcemia,hypomagenesemiasevere：腹泻病英文-医学课件腹泻病英文-医学课件Whentoseeadoctor?Age<3mWeight<8kgHistoryofprematurebirth,chronicmedicalconditions,orconcurrentillnessFeverof38ºCorhigherininfantsyoungerthan3monthsor39ºCorhigherinchildrenaged3-36monthsVisiblebloodinthestoolWhentoseeadoctor?Age<3mHigh-outputdiarrheaPersistentemesisSignsofdehydration,includingsunkeneyes,decreasedtears,drymucousmembranes,anddecreasedurineoutputMentalstatuschangesInadequateresponsestooralrehydrationtherapy(ORT)High-outputdiarrheaManifestationsofsomeenteritisManifestationsofsomeenterit
RotavirusdiarrheaMaincause<3yRotavirusdiarrheaMainca6m-24mAutumnandwinterFecal-oral/airwaytransmissionIncubation:1-3daysAccompaniedbyfeverandURI6m-24mVomitprecedesdiarrheaWatery,odorless,inlargeamountIsotonicdehydration,electrolyteacid-basedisturbancesTemporarylactoseintoleranceSelf-limiting,lastsfor3-8dVomitprecedesdiarrheaEnterotoxigenicE.coli(ETEC)
maincause>3ysAbruptVomit,nofever,nosystemicsymptomsYellow-greenwaterystoolDehydration,electrolytedisturbances,acidosisSelf-limittingEnterotoxigenicE.coli(ETECInvasivebacterialenteritis
Abruptonset,highfeverDiarrheafrequently,mucousandblood,Nause,vomiting,abdominalpain,cramps,tenesmusSystemictoxemia:chills,malaise,hyperpyrexia,convulsion,shockWBC+，RBC+Stoolculture:+Invasivebacterialenteritis
AFungusWeakness,useantibiotics/cortisteriodforalong-termCandidaalbicans<2ys,sometimesaccompaniedwiththrushWaterystoolwithfoamandmucosa,soy-beanresidue-likethingsFungalspore
andmyceliumFungusWeakness,useantibiotic
Persistingorchronicdiarrhea
PersistingorchronicddiarrheamalnutritonMajorContributortoMalnutritiondiarrheamalnutritonMajorContrDiagnosis
“
soap”Subject:historyObject:physicalexaminationlaboratoryexaminationstoolmicroscopicexaminationstoolcultrure/ELISAelectrolyte/acid-basedisturbances?Assessment:dehydration?malnutriton?PlanDiagnosis“soap”SubjecDifferentialdiagnosisFewWBCinstoolPhysiologicaldiarrheaLactasedeficiencyAllergyManyWBCinstoolShigellosisNecrotizingenterocolitisAmebicdysenteryIntussusceptionDifferentialdiagnosisFewWBCTreatmentRegulatedietIntensivenursingcareSymptomatictreatmentTreatmentRegulatedietMedicationControlinfection:antibiotic?MicroecologytherapyIntestinalmucosalprotectiveagentFluidtherapy,correctwaterandelectrolytedisturbances(nextclass)ZincsupplementWHOandUNICEFrecommendedtakezincfor10-14daysduringdiarrheaespecialinhigh-prevalencearea<6mo:10mg/d;>6mo:20mg/dMedicationSummaryDiarrheaisacommondiseaseininfant,it’sthemaincauseofmortalityRotavirusisthemajorpathogentocauseacutediarrheaMilddiarrheaisself-limitingModerateandseverediarrheamayleadtodehydration,acid-base,electrolytedisturbancesProperfluidtherapyisthekeySummaryDiarrheaisacommondiPreventionRecommendbreastmilkfeedingFormgoodhealthhabitsHandhygieneAvoidlong-termabuseofbroadspectrumantibioticsRotavirusvaccination.Protectiverate>80%PreventionRecommendbreastmilInfantileDiarrhea
InfantileDiarrhea
腹泻病英文-医学课件outlinePrevalenceDefinitionPredisposingfactorsEtiologyPathogenesisManifestationsDiagnosis DifferentialdiagnosisTreatmentPrognosisPreventionrotavirusdiarrheaenterotoxigenicE.coli(ETEC)invasivebacterialenteritisfungusoutlinePrevalencerotavirusdia腹泻病英文-医学课件Question:What’skindofstoolisnormal?stoolQuestion:What’skindofstoolDefinition——isasyndromewithincreasedstoolfrequencyandchangesofcharacterofstoolwhichcausedbypathogensinfectionorotherreasons.Waterystoolwith/withoutmucous,bloodystoolFrequency≥3timesaday,Stoolvolume>10g/kg.dThemainreasoncausemalnutritionandgrowthretardation
Definition——isasyndromewithPredisposingfactorsImmaturedigestivefunctionGastricacidityDigestiveenzymesRapidgrowthPoorimmunefunction(hostdefenses)ImmunoglobulinsDisturbedentericbacterialfloraFormulafeeding
PredisposingfactorsImmaturedEtiology
infection
diarrhea
non-infection
IntestinalextraintestinaldietallergyweatherEtiologyinfec
InfectiousfactorsVirus(70%)RotavirusAdenovirusAstrovirus,NorwalkvirusCalicivirusNorovirusEnterovirusBacteriaEnteropathogenicE.coliCampylobacterjejuniShigellaSalmonellaStaphylococcus
aureusClostridiumdifficileFungi
CandidaalbicansParasiteInfectiousfactorsViruDevelopedcountryDevelopingcountryDevelopedcountryDevelopin
NoninfectiousfactorsDietWeatherColdHotImproperdietAllergyLactasedeficiencyNoninfectiousfactorsDietPathogenesisOsmoticdiarrheaSecretorydiarrheaExudativediarrheaAbormalmotility
notone,buttogetherPathogenesisOsmoticdiarrheaIntestinalvillicryptepitheliumIntestinalvillicryptepithelivirusenteritis
virusduplicate
mucosalinjury，villidamagedisaccharidaseactivitycarrierglucose,fatabsorption
osmoticpressurewaterydiarrhea
InfectionvirusenteritisInfectionBacterialenteritis
ETECenterotoxinheatlabiletoxinheatstabletoxinACGCATPcAMPGTPcGMPinhibitNa+,Cl-andwaterabsorbtion，promotesecreteCl-Na+,Cl-andwaterinceasedmorethancolonicabsorptionlimitwaterydiarrhea
BacterialenteritisNoninfection
overeatingfoodgatherinUGIPHbacteriamoveandreproduceendogenousinfection
fermentorganicacid(lactose,acetic-acid)amineliverdetoxificationfunctioninsufficiencyosmotictoxinenterintobloodbowelmovementtoxicitysymptomdiarrhea,dehydration,electrolytedisturbances,acidosisNoninfectionManifestationsClinicaltypesActuediarrhea:<2wPersistantdiarrhea:2w-2mChronicdiarrhea:>2mManifestationsClinicaltypesAcutediarrheaAcutediarrheaCommonclinicalmanifestations
Mild：Mainlycausedbydietaryfactorsorextraintestinalinfections.Waterystoolwithsour,foam,milkvalve,nopusorblood.Withoutdehydrationandtoxicitysymptom.Mostofthemrecoverinafewdays.Commonclinicalmanifestationssevere：Causedbyintestinalinfections>10/dwithmucus,pus,bloodStooltest:WBC+,RBC+GIsymptoms:vomit,anorexia,abdominalpain,distentionSystemicsymptoms:toxicity,shock,comaModerate,severedehydrationMetabolismacidosisElectrolytedisturbances：hypokalemia,hypocalcemia,hypomagenesemiasevere：腹泻病英文-医学课件腹泻病英文-医学课件Whentoseeadoctor?Age<3mWeight<8kgHistoryofprematurebirth,chronicmedicalconditions,orconcurrentillnessFeverof38ºCorhigherininfantsyoungerthan3monthsor39ºCorhigherinchildrenaged3-36monthsVisiblebloodinthestoolWhentoseeadoctor?Age<3mHigh-outputdiarrheaPersistentemesisSignsofdehydration,includingsunkeneyes,decreasedtears,drymucousmembranes,anddecreasedurineoutputMentalstatuschangesInadequateresponsestooralrehydrationtherapy(ORT)High-outputdiarrheaManifestationsofsomeenteritisManifestationsofsomeenterit
RotavirusdiarrheaMaincause<3yRotavirusdiarrheaMainca6m-24mAutumnandwinterFecal-oral/airwaytransmissionIncubation:1-3daysAccompaniedbyfeverandURI6m-24mVomitprecedesdiarrheaWatery,odorless,inlargeamountIsotonicdehydration,electrolyteacid-basedisturbancesTemporarylactoseintoleranceSelf-limiting,lastsfor3-8dVomitprecedesdiarrheaEnterotoxigenicE.coli(ETEC)
maincause>3ysAbruptVomit,nofever,nosystemicsymptomsYellow-greenwaterystoolDehydration,electrolytedisturbances,acidosisSelf-limittingEnterotoxigenicE.coli(ETECInvasivebacterialenteritis
Abruptonset,highfeverDiarrheafrequently,mucousandblood,Nause,vomiting,abdominalpain,cramps,tenesmusSystemictoxemia:chills,malaise,hyperpyrexia,convulsion,shockWBC+，RBC+Stoolculture:+Invasivebacterialenteritis
AFungusWeakness,useantibiotics/cortisteriodforalong-termCandidaalbicans<2ys,sometimesaccompaniedwiththrushWaterystoolwithfoamandmucosa,soy-beanresidue-likethingsFungalspore
andmyceliumFungusWeakness,useantibiotic
Persistingorchronicdiarrhea
Persistin
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