Quinet B
Service de consultation de pédiatrie, Hôpital d'enfants Armand-Trousseau, Paris.
Rev Prat. 1996 Jan 15;46(2):177-83.
Acute diarrhoea is one of the major causes of outpatient paediatric consultation, especially during infancy. An infectious cause should be suspected on the acute onset of diarrhoea associated with fever. The specific pathogen is seldom investigated and individualized. Rotavirus has been recognized as the most important enteric pathogen, particularly in infants during winter months. It may be responsible for nosocomial infections in hospital and outbreaks in day-care centers. Bacteria may cause a diarrhoea by elaboration of enterotoxins, by invasiveness, or both. Use of antibiotic is usually not necessary even in bacterial infections because they are self-limited. Choice of the antibiotic is complicated by the rapid emergence of resistant pathogenic strains. The first step is rapid assessment of the hydratation status of the patient. Fluid and electrolytes replacement is the mainstay in the treatment of infectious diarrhoea of any cause.
急性腹泻是儿科门诊就诊的主要原因之一,在婴儿期尤为常见。腹泻伴发热急性起病时,应怀疑有感染性病因。很少对具体病原体进行调查和个体化诊断。轮状病毒已被确认为最重要的肠道病原体,尤其是在冬季的婴儿中。它可能导致医院内感染及日托中心的疫情爆发。细菌可通过产生肠毒素、具有侵袭性或两者兼而有之来引起腹泻。即使是细菌感染,通常也无需使用抗生素,因为这些感染具有自限性。耐药病原菌菌株的迅速出现使抗生素的选择变得复杂。第一步是快速评估患者的水化状态。补充液体和电解质是治疗任何病因引起的感染性腹泻的主要方法。