Non-Typhi Salmonella gastroenteritis in children presenting to the emergency department: characteristics of patients with associated bacteraemia
| Autor: | Yechiel Schlesinger, S. Benenson, M. Bar-Meir, B. Rudensky, A.M. Yinnon, D. Raveh |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
Microbiology (medical) Emergency Medical Services Salmonella medicine.medical_specialty Adolescent diagnosis Salmonella gastroenteritis Bacteremia medicine.disease_cause children Patient age Internal medicine medicine Humans Israel Child Erythrocyte sedimentation business.industry Infant General Medicine Emergency department medicine.disease Surgery Infectious Diseases El Niño Child Preschool Salmonella Infections Bacteraemia Female Typhi salmonella business gastroenteritis |
| Zdroj: | Clinical Microbiology and Infection. 11:651-655 |
| ISSN: | 1198-743X |
| Popis: | The records of children with Salmonella gastroenteritis only (n = 97), and those with associated bacteraemia (n = 64), seen in one medical centre during a 12-year period, were analysed retrospectively. Mean patient age was 2.24 +/- 2.8 years (range, 0.05-16 years), and 49% were male. Children with bacteraemia presented after a longer duration of symptoms (7.0 +/- 6.9 vs. 3.9 +/- 4.6 days, p 0.0002), and had higher erythrocyte sedimentation rates (45 +/- 22 vs. 33 +/- 22 mm/h, p0.02) and lactate dehydrogenase values (924 +/- 113 vs. 685 +/- 165 IU/L, p 0.001). There was a trend in bacteraemic children towards immunosuppression (6.3% vs. 1.0%, p 0.08) and a lower number of siblings (2.9 +/- 1.9 vs. 3.8 +/- 2.7, p 0.063). Non-bacteraemic children had a more severe clinical appearance, and a higher percentage had a moderate to bad general appearance (51.5 vs. 29.7%, p0.01), with dehydration (37.1 vs. 18.8%, p 0.02) and vomiting (58.8 vs. 39.0%, p 0.02). Laboratory dehydration indicators were also markedly worse in non-bacteraemic children, with urine specific gravity of 1020 +/- 9.4 vs. 1013 +/- 9.0 (p 0.0002), base excess of - 4.2 +/- 3.0 vs. - 2.5 +/- 3.4 mEq/L (p 0.01), and blood urea nitrogen of 10.1 +/- 7.0 vs. 7.4 +/- 4.5 mg% (p 0.002). Thus, the clinical presentation of bacteraemic children was more gradual, and associated gastroenteritis and dehydration was less pronounced. These findings may contribute in part to the inadvertent discharge of bacteraemic children from the emergency department. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|