Toxic Dysentery Treatment Options for Children

Toxic dysentery, also known as toxic bacillary dysentery, primarily affects children between the ages of 2 and 7. This severe form of bacterial infection is characterized by a sudden onset, high fever, and pronounced systemic toxicity. It can lead to life-threatening complications such as septic shock and encephalopathy. One of the challenges in diagnosing this condition is that early gastrointestinal symptoms may be mild or even absent. However, a rectal swab test often reveals the presence of mucus, pus, and blood in the stool, which is a key indicator of the disease.

Immediate Medical Intervention

The treatment of toxic dysentery requires prompt and aggressive medical intervention. The primary therapeutic goals include reducing body temperature, controlling seizures, relieving vascular spasms, preventing and managing shock and cerebral edema, and administering appropriate antimicrobial therapy. Fever management is particularly crucial, as high temperatures can trigger seizures that worsen brain hypoxia and swelling. Physical cooling methods should be initiated immediately, and if necessary, antipyretic medications such as metamizole can be used to bring the body temperature below 38°C.

Shock and Organ Support

Management of Septic Shock

Antishock treatment is a cornerstone of therapy in toxic dysentery. This involves fluid resuscitation to expand blood volume, correction of acid-base imbalances, improvement of microcirculation, and support of vital organ functions. These measures are essential to stabilize the patient's condition and prevent further deterioration.

Respiratory Failure Treatment

Respiratory failure is a serious complication associated with toxic dysentery, often linked to impaired cerebral microcirculation, brain hypoxia, and subsequent cerebral edema. Prompt recognition and treatment of respiratory distress are critical to improving outcomes. This may include mechanical ventilation and other supportive therapies to ensure adequate oxygenation.

Antibiotic Therapy

Antimicrobial treatment is essential in combating the bacterial infection. The choice of antibiotics is generally similar to that used for acute bacillary dysentery, but intravenous administration is preferred in the early stages of treatment. Effective options include levofloxacin, ciprofloxacin, and ceftriaxone. Once the patient shows signs of clinical improvement, the treatment can be transitioned to oral antibiotics for continued therapy.