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DIARRHOEA
( 2 )
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ANTIMICROBIAL
1. Cholera
2. Shigellosis3. Amoebiasis
4. Giardiasis
Acute Diarrhoea
(WHO)
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ANTIMICROBIAL (WHO)
1. CHOLERA TETRACYCLIN 12,5 mg/Kg BW - 4 x a day
3 days
2. HI!ELLA "YENTERY 5 mg T#$ % 25 mg #&/Kg BW - 2 x a day
5 days
3. A#OEBIAI #ETRONI"A'OLE 1(mg/Kg BW - 3 x a day
5 days
4. !IAR"IAI #ETRONI"A'OLE 5 mg / Kg BW - 3 x a day
5 days
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SIDE EFFECT OF ANTIMICROBIAL
1. CHANGING OF INTESTINAL FLORA2. OVERGROWTH:
- MONILIA
- ENTEROCOCCUS
- ANAEROB- PSEUDOMONAS
3. MUCOSAL INJURY
. IRRITATION!. PSEUDOMEMBRANOUS ENTEROCOLITIS
". BLOOD DYSCRASIA
#. VOMITING
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ANTI"IARRHOEAL)*+d as .".A0
1. B$%&' M$&&*+
2. S+$$' C$*,,+&*/
3. C0,
A dg a a+ s67+ y 689
masm+ 6 a 6 6+6: sym;6ms6< da6a
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1.UNABSORBEDANTIMICROBIAL :
StreptomycinNeomycin
Hydroxy!ino"inUn#$%or$ed S!"
'. ANTIMOTILIT( :) Loper#mide) Dip*enoxy"#te
+. ADSORBENT :,#o"in-pectinC*#rco#"At#p!"it - %mectite
/. ANTISECRETOR( :S#"icy"#te AcidC*"orprom#0ine
. TRIAL:L#cto$#ci""!%23r!ctoo"io %#cc*#rid#
Antidi#rr*oe#"
NB : 1 to / NO RECOMMENDED
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AOLIN
1. S+4'+& 0'-+,,4& &*&+0+$*
2. N$ 5&*&6+ * 0$*7 ,+$$', $*,,+&*/3. S40&,, +8& &66&+ $6 *+5$+,
. C$,&+ &66&+
!. M'5,$0+$*
IODOHIDRO9Y UINOLINE
1. N$ 5&*&6+
2. I* J* ;;< S454+& M/&'$ O+ N&40$+8/
( SMON)
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DIARRHOEA
DEHYDRATION COMPLICATION
REHYDRATION
-RINGER=S LACTATE-RINGER=S ACETATE
-ORS
- ELECTROLYTES
IMBALANCE- ACIDOSIS METABOLIC
- FEVER
- CONVULTION- HYPOGLICEMIA
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OPIATES > SPASMOLYTICA
1. INCREASE THE DURATION OF FEVER2. PROLONG PASSAGE OF PATHOGENS
3. DECREASE OF BOWEL PERISTALSIS
. INCREASE THE DURATION OF
PROLIFERATION?TOSIN PRODUCTION >
INVASIVE BY MICROORGANISMS
!. GUTPARALYSIS
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ELECTROLYTES - ACID BASE
INITIAL
DIAGNOSIS
REHYDRATION
TREATMENT
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ELECTROLYTE = ACI" BAE
INITIAL
IONATRE#IA"EHY"RATION
REHY"RATION
HY$ONATRE#IA
"IL*TIONAL
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REHYDRATION
ACIDOSIS METABOLIC
H @ #.2
HCO3-; 1-2 E7 BW
- LUNGS DYSFUNCTION (-)
- HYPOALEMIA (-)
DEHYDRATION ACIDOSIS METABOLIC
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REHYDRATION
HYPERNATREMIA
( < 1! E')
- IVFD STOPPED
- PLAIN WATER
DEHYDRATION HYPERNATREMIA
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REHYDRATION
HYPONATREMIA
( @ 13! EL)
S/+
H/$N
A6+&0
R&8/0+$*
A,/+
H/$N
NC' 3 F'4 R&,+0+$*RL
N(E); (13! N',) ?" BW (7)
DEHYDRATION HYPONATREMIA
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REHYDRATION
HYPOALEMIA
D008$& () D008$&
HYPERALEMIA
R&*' F4*+$*
ECGRL
N 5N
$0' 0(4+$ 3 E 7BW /)
A4+& R&*' F'40&
F'4,
R&,+0+$*
DEHYDRATION HYPO HYPERALEMIA
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FEVER
TEMPERATURE DOWN
COOLING DRUGS
- U*'$+8&
- W& $6 ,%&+
- F***7
- T& ,$*7*7
1. P0&+$' :
3 77/ - 3 $,&,
2. - A&+/' S'/' A
- M&6&* A
N$ 0&$&*&
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CONVULSION
D&: 1 77/ 3 - $,&, &0 0&+'
H/$7'& (@! 7)
C$
D&+0. 1 IV! L 7 BW
%+8* ! *4+&,
A'&0+
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V. CHOLERAE
O1 N$* O1(N$* A77'4+*5'&)
- B$+/& - E'+$0
- C',,
- S&0$+/& - O7%
- I*5
- H$K O2 - 13O1 - 12
O13
B&*7' S+0*
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ENTEROTO9IN
A5,$0+$* $6 N
* V''$4, C&'', 0& *++
S406& R&&+$0
S&0&+$* $6 C'-
* C0/+ C&'',
A&*/' C/',&
C - AMP
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>::
Cy;
B67: Lm+
As6;6+
6+
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V. CHOLERAE
JEJUNUM
- COPIOUS DIARRHOEA
- FISHY RICE WATER STOOLS
- FEVER (-)
- ABDOMINAL PAIN (-)
- RAPID DEHYDRATION > SHOC
- BIOCHEMICAL ()
- HISTOLOGY (-)
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DIAGNOSIS
- CLINIC
CHILDREN < 2 YEARS
SEVERE DEHYDRATION
THE OTHER CHILDREN ()
- LABDAR FIELD MICROSCOPE
CULTURE
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T8 W+&0 > E'&+0$'/+&,R*7&0=,
L++& I.V.
FEEDING
ANTIMICROBIALT&+0/'*& $0
D$//'*&
R&8/0+$* > M*+&**&
F&' S$4
( 11 E L)
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DYSENTERY SINDROME ; BLOODY DIARRHOEA
1. DYSENTERY
- BACILLARY
- AMOEBIC
2. E*+&0$$'+,
- C$%, ' ''&07/
3. T0840,,
. O+8&0, - E*+&0$ *,& E $'
- C. K&K4*
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BACILLARY DYSENTERY
; SHIGELLOSIS
COLON
S. DYSENTERIAE
S. FLE9NERI
S. BOYDII
S. SONNEI
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SHIGELLA
INVASIVE SHIGA TO9IN
INHIBITION OF
PROTEIN SYNTHESIS
CYTOTO9IC
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SHIGELLA
- WATERY DIARRHOEA- BLOODY DIARRHOEA
- TENESMUS
- ABDOMINAL PAIN- URGENCY
- FEVER- CONVULSION
- SEPTIC
-HEMOLYTIC UREMICSYNDROME
- TO9IC MEGA COLON
- RECTAL PROLAPS
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T8
1. WATER > ELECTROLYTES
2. FEEDING
3. - SELF LIMITED - SEVERE TMP - SM9
C&6&:
77/
2 $,&,
*'
,'*
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AL#ONELLOI
TY$HOI"AL ENTERIC E>ER ?
-. TY$HOI" TY$HOI" E>ER
-. $ARATY$HOI" $ARATY$HOI" E>ER
NON TY$HOI"AL ? AL#ONELLA
!ATROENTERITI
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IN"ICATION O ANTI#ICROBIAL
TREAT#ENT IN AL#ONELLA
!ATROENTERITI
3 #ONTH O A!E
2. OL" "EBILITATE" $ATIENT
3. "YENTERY OR# E$ECIALLY
ILLNE @ 5 "AY
4. I##*NOCO#$RO#IE" ? TEROI",
#ALI!NANCY
5. BACTERIAE#IA
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I*6*+ 1 $*+8, $6 7&? %, ++& +$ 8$,+' %+8I*6*+ 1 $*+8, $6 7&? %, ++& +$ 8$,+' %+8
008$&.008$&.O* &*+$*O* &*+$* :: BW ; 7QBW ; 7Q *6*+ %&'' > '&0+Q*6*+ %&'' > '&0+Q
&/&, :&/&, : ,4*&*,4*&* Q 0*, &7&0'/Q ,* *8 7$&,Q 0*, &7&0'/Q ,* *8 7$&,
5:4'/.5:4'/.
4&,+$* :4&,+$* :
1.1.D&8/0+$*..D&8/0+$*..
2.2.A$4*+ $6 6'4, %'' 5& 7&*A$4*+ $6 6'4, %'' 5& 7&*
3.3.I6 +8& 55/ 0&*=+ 5'& +$ 0*? %8+ * $6I6 +8& 55/ 0&*=+ 5'& +$ 0*? %8+ * $6*+&0&*+$* , *&&&*+&0&*+$* , *&&&
.I6 +8& 55/ , 0*, *$0''/? %8+ +/& $6.I6 +8& 55/ , 0*, *$0''/? %8+ +/& $6
&8/0+$*&8/0+$*
E&0,& :