All issues > Volume 27(12); 1984

Original Article

J Korean Pediatr Soc. 1984;27(12):1168-1175. Published online December 31, 1984.

Clinical Obsertation and Treatment in Child Shigellosis.

C S Sohn¹, I S Lee¹, E H Cho¹, K B Kim¹

¹Dspartment of Pediatrics, Kwangju Christian Hospital，Korea

Abstract

Clinical Observation and Treatment in Child Shigellosis C.S. Sohn, M.D., I.S. Lee, M.D., E.H. Cho, M.D. and K.B. Kim, M.D. Dspartmznt of Pediatrics, Kwangju Christian Hospital，Korea On 51 cases of infants and children who .had been bacterologically diagnosed as shigellosis and treated with various regimens from March, 1980 to August, 1983 in Kwang-ju Christian Hospital observations were made as to the clinical manifestation and to the effectiveness of the therapy. Among 35 cases 16 were males, giving sex ratio of 2.2 : 1. Majority(71%) of casss were between 1 and 5 years of age. The peak incidencs was noted in summer, although it occurred all the year round, even in winter. Major clinical symptoms were diarrhea (100%), high fever (96%), vomiting (51%) and convulsion (35%). Abdominal pain was noted in 12 cases (24%), but was not detscted below 3 years of age. Dehydration was noted in 36 cases (69%). The leukocyte count in peripheral blood smear revealed increase in 24 cases (47%), within normal range in 20 cases (39%), and decrease in 7 cases (14%). 29 cases (75%) were noted with more than 5% of band-form neutrophils. In bacteriological studies, shigella flexneri was isolated most frequently (47 cases, 92%), followed by shigella sonnei (2 cases, 4%). The antibiotics to which the causative agents showed resistance were Chloramphenicol, Carbenicillin, Tetracyclin, Ampicillin, Colimycin, Erythromycin and Cefalothin. Gentamycin, Kanamycin and Nebsin were more sensitive to those which are of limited use because of toxicity. The average duration until clinical improvement by the various regimens were as follows： 4.1 days in 8 cases with the combined regimen of Rifampin and TMP/SMX; 4.3 days in 13 cases with the combined regimen of Rifampin and Ampicillin; 5.3 days in 6 cases with Ri- fampin alone; 5.2 days in 15 cases with the combined regimen of TMP/SMX and Ampicillin; 5.8 days in 9 cases with the combined regimen of Ampicillin and Gentamycin, suggesting that the combined regimen of Rifampin and TMP/SMX is the most effective. However, as there was a significant difference in frequency of diarrhea already in the first hospital day, it is therefore impossible to state with certainty that the regimen is superior to others.

Keywords :Shigellosis; Clinical observation; Combination therapy.