All issues > Volume 25(10); 1982

Original Article

J Korean Pediatr Soc. 1982;25(10):1022-1038. Published online October 31, 1982.

A Clinical Study and Diagnostic Value of Fecal Leukocytes in Childhood Dysentery.

Y B Kim, C I Abn

¹Dept, of Pediatrics、College of Medicine，Kyung Hee University Secul，Kcrea

Abstract

Ninety four cases of dysentery who were admitted to the pediatric department of Kyung Hee University Hospital from the 1st Jan. 1979 to the 31st Oct. 1981 were analyzed clinically and bacteriologically. At the same time, stools from subjects with diarrhea were examined microscopically for leukocytes using Wright stain to confirm its diagnestic value. The results are as follows: 1. The causes of the dysenteries were: tacillary dysentery 29 cases (31%), amebic dysentery 16cases (17%), mixed infection with shigella and ameta 49 cases (52%). The most common pathogenic strain was Shigella :flexneri and the others were as following order: Shigella sonnei, Shigella dysenteriae. 2. The children of 2〜3 years of age were most frequently affected (27.6%) and 78. S% of total patients belonged to 1 〜6 years of age. Sex distritution revealed that leys had a little higher incidence than girls. 3. Symptoms and signs on admission were diarrhea, fever, ahdominal pain, vcmiting, dehydration and CNS symptom in its order of frequency. Amebic dysentery was milder than bacillary dysentery. 4. Fecal leukocytes were found as follows: 75.of bacillary dysentery, 50.0% of amebic dysentery, 79.6% of mixed infection. No fecal leukocytes were found in patients with paren teral diarrhea and healthy control subjects. The predominant cell types in dysentery were polymorphonuclear leukocytes, whereas in typhoid fever mononuclear lenkccytes. Fecal leukocyte Study was valuable in diagnosing dysentery. 5. Ninety six point two percent of Shigella were resistant to cartenicillin, 96.2% to chlora- mphenicol, 96.2% to teramycin, 95.0% to streptomycin, 88.5% to ampicillin, 1.3% to cepha- losporin, 1.3% to kanamycin. But no resistant strains were found in amikacin and gentamicin. 6. In clinical evaluation, the percentage of response by antibiotics was as follows: ampicillin 28.6%, TMP/SMX 83.3%, gentamicin 100%, rifampin 100%. Gentamicin and rifampin appeared to be the most effective drugs for the treatment of shigellosis. Metronidazole is found to be ■effective in the treatment of amebic dysentery clinically and parasitologically.

Keywords :Dysentery, fecal leukocytes.