Journal of the Korean Pediatric Society 1971;14(7):433-444.
Published online July 31, 1971.
Studies on Entamoeba Histolytica Infection in Infants and Children
Chan Yung Kim
Department of Pediatrics, College of Medicine Pusan National University
小兒의病疾 아메바 (Entamoeba histolytica) 感染에 關한 硏究
金贊榮
整山大學校 醫科大學 小兒科學敎室
Abstract
The study was carried on 79 infants and young children under 5 year of age, who were a part of 112 children with amebic dysentery treated either at Save the Children Fund Clinic and Pusan Children’s Charity Hospital, during March to October 1970. The cases having pneumonia and acute infectious diseases were not included in the study. 1)Seasonal incidence: In addition to the 79 cases in the present study, those 151 children (under 15 year) from Pusan Children^ Charity Hospital and 647 from the Save the Children Fund Clinic, during, 1968 to 1970, were included, totaling 798 cases, 169 cases were treated in June (21.2%) showing the highest incidence and 398(49. 6%) seem between May and July and these were roughly the half of the total cases of a year. The incidence was highest in the rainy early summer season. 2)Clinical Observation: Concerning the severity of diarrhea on their first examination, 26. had mild diarrheal stools, 43. Q% moderate degree of diarrhea and 30. 4% had severe diarrhea. That is 73. 4% had a moderate or severe degree of diarrhea. As to the character of the stool, 43. 0% of cases had mucous stools, 25. 3% mucus and blood, 3.3% had grossly bloody stool and 27. 9% had watery stools. And so watery and mucous stool were found most frequently. As the initial complaint, restless and irritability were most common(70. 7%) and 56. 6〜65. 8% of cases showed sings of thirst, diminished urine output and weight loss, 19.2% showed signs of moderate and severe dehydration and the rest, 80. 8%, showed signs of mild dehydration or merely not dehydrated. In 18. 9% high fever (above 38. 5°C) was noted and most other cases had mild fever. Leukocytosis was found in only 16. 4% and in most the white cells were within normal limits. Complication: As the cases having pneumonia, acute infectious disease and severe malnutrition in addition to amebic dysentery were excluded, as mentioned earlier, true complications from am-ebiasis were infreqent. Genito-anal skin rashes were seen in 29.1%, stomatitis (oral thrush) in 11. 5% and anal prolapse in 2. 5% respectively. 3)To evaluate the effectiveness of some anti-amebic drugs, children were given, metronidazole only, metronidazole with tetracycline and diodoquin with tetracycline. a)Metronidazole alone in doses of 50mg/kg/day was given for 7 day. The stools improved within 4 days in 71. 9%, Except for 2 cases, all improved within 7 days. In 62. 5% of cases, amebic cysts disappeared from the stools with 4 days. Except for 2 cases, all showed abscence of cysts in stools within 7 days. b)The combination of metronidazole with tetracycline resulted in slightly earliar improvement in. stool character than did metronidazole alone, but no great difference was found in the time taken for disappearace of cyst from the stools. c) In the cases treated with diodoquin and tetracycline, the results were less effective than the former two regimens and one case treated thus had a recurrence of amebic dysentery later.


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