Pediatr Gastroenterol Hepatol Nutr.  2017 Jun;20(2):107-113. 10.5223/pghn.2017.20.2.107.

Clinical Characteristics and Ultrasonographic Findings of Acute Bacterial Enterocolitis in Children

• Chun P
• Lim TJ
• Hwang EH
• Mun SW
• Lee YJ
• Park JH

• KMID: 2384824
• DOI: http://doi.org/10.5223/pghn.2017.20.2.107

Abstract

PURPOSE
This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens.
METHODS
Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed.
RESULTS
Twenty-four patients (70.6%) were male. The mean age of the patients was 8.5±6.2 (range, 1.1-17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p<0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p<0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen.
CONCLUSION
Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.

Keyword

Enterocolitis; Child; Ultrasonography

MeSH Terms

Abdominal Pain
Bacteria
C-Reactive Protein
Campylobacter
Campylobacter Infections
Child*
Clostridium difficile
Colon
Diagnosis
Enterocolitis*
Humans
Ileum
Male
Medical Records
Multiplex Polymerase Chain Reaction
Retrospective Studies
Salmonella
Shiga-Toxigenic Escherichia coli
Shigella
Staphylococcus aureus
Ultrasonography
C-Reactive Protein

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