Foamy, fishy smelling loose stools

Introduction Epidemic diarrhea of newborn refers to the health search in the maternity baby room or hospital neonatal ward outbreak of epidemic diarrhea health search due to impaired neonatal immune function and environmental factors, prone to infection, health search for pathogens with bacteria Viruses, fungal parasites are more common mainly through the contaminated dairy water in the maternal birth canal, the nipple utensils and adult carriers. In the epidemic, the nucleotide or gene configuration of rotavirus in most children's stools is considered to be a common cause.

Cause

1. Bacteria: Escherichia coli is more common, and pathogenic Escherichia coli (EPEC), toxic Escherichia coli (ETEC) and hemorrhagic Escherichia coli (EHEC) have occurred in newborns. Epidemic diarrhea, especially EPEC is a common cause, and is highly prevalent. Sometimes it can cause the prevalence of diarrhea in infants throughout the ward and even spread outside the hospital, causing the prevalence of babies throughout the region. The first case of the epidemic began with diarrhea before and after delivery, or the presence of Escherichia coli in the cervix during infection.

2. Virus: Rotavirus is one of the most common pathogens causing neonatal epidemic diarrhea. It is mainly transmitted through the faecal-oral route. Healthy adults can be used as carriers, and infected newborns are also important infectious agents. Rotavirus is more stable in the environment and is not easily inactivated by the caregiver. It has also been reported that rotavirus can spread through the respiratory tract and placenta. However, rotavirus is found in the stool and cannot be considered as the pathogen of diarrhea. It can also be found in normal stools. In the epidemic, the nucleotide or gene configuration of rotavirus in most children's stools is considered to be a common cause. Coxsackie virus, echovirus, intestinal adenovirus, etc. can also cause neonatal epidemic diarrhea.

3. Fungi: Long-term use of antibiotics can be secondary to fungal infections of the sputum net, which is more common with Candida albicans.

4. Parasites: Trichomonas, P. cerevisiae, and cryptosporidium can also cause neonatal epidemic diarrhea.

an examination

Related inspection

Blood routine fecal traits fecal smell fecal bacteria culture routine

Clinical manifestations:

1. Gastrointestinal symptoms:

Diarrhea several times a day or more than 10 times, stool characteristics and pathogens can be a thin watery stool mucus, bloody children often have loss of appetite, bloating, vomiting and flattening. Neonatal epidemic diarrhea caused by different pathogens has certain characteristics:

(1) Escherichia coli enteritis: pathogenic Escherichia coli enteritis stool is watery, egg-like soup-like smell of sputum; toxigenic Escherichia coli enteritis stool is a dilute water; invasive Escherichia coli enteritis The stool is mucus pus and bloody, with a stench and a small amount of stool.

(2) Salmonella typhimurium enteritis: stool characteristics are more dilute, can be watery jelly-like, black-green or gray-white with obvious odor.

(3) Rotavirus enteritis: acute onset, often fever, stool water, a large amount, the odor is not obvious.

(4) Staphylococcus aureus enteritis: stools are mostly yellow-green, dark green, watery, with a stench.

(5) Fungal enteritis: The stool is yellow-green and watery, or tofu-like, with more foam.

2. Systemic symptoms:

Often have a fever, apathetic, crying and uneasy, severe cases of drowsiness, pale lips and cyanosis.

3. Water and electrolyte balance disorder:

Neonatal diarrhea often occurs in a short period of time, such as dehydration acidosis, hyponatremia, hypokalemia and other complications. The sputum net is gray, the skin pattern is cold, and the urinary sputum net appears shock.

Differential diagnosis

Infected and non-infectious diarrhea are easily identified based on clinical signs of infection. Intestinal infectious diarrhea and extraintestinal infectious diarrhea, the former has severe diarrhea symptoms, the latter only health search is symptomatic diarrhea, with the performance of primary infectious diseases, but also easy to identify the epidemic diarrhea Medical history and laboratory tests can confirm the diagnosis.

1. Intestinal infectious diarrhea:

(1) Epidemiological history Health search: According to the characteristics of the history of the disease for identification and analysis, the baby room has diarrhea, the epidemic sputum network suggests that there may be fever in the mother of Escherichia coli, Salmonella typhimurium, Proteus or viral enteritis. Early broken water production or long history of suffocation, etc., consider possible health search for infectious diarrhea

(2) clinical manifestations: according to the characteristics of symptoms and signs for differential analysis, early diarrhea, hypothermia, poor color, vomiting stool, mucus or pus, microscopic examination, red, white (pus), blood cell health search, suggestive of infectious diarrhea Into the sputum net smear staining examination, culture or virus isolation can identify enteritis nature (pathogen) health search.

2. Parenteral infections:

There are symptoms of infection and poisoning, and there are a few cases of white blood cells.

3. Non-infectious diarrhea:

Such as sugar digestion and absorption, fat digestion and absorption and other non-infective performance.

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