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KMID : 1038820170200020107
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Pediatric Gastroenterology, Hepatology & Nutrition
2017 Volume.20 No. 2 p.107 ~ p.113
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Clinical Characteristics and Ultrasonographic Findings of Acute Bacterial Enterocolitis in Children
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Chun Peter
Lim Taek-Jin
Hwang Eun-Ha
Mun Sang-Wook
Lee Yeoun-Joo
Park Jae-Hong
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Abstract
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Purpose: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens.
Methods: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographicfindings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed.
Results: Twenty-four patients (70.6%) were male. The mean age of the patients was 8.5±6.2 (range, 1.1-17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p＜0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p＜0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrateddiverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen.
Conclusion: Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detectthe disease extent and severity.
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KEYWORD
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Enterocolitis, Child, Ultrasonography
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