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Interventions in diarrheas of infants and young children.

To prevent diarrhea, efforts must be directed toward decreasing environmental contamination of enteropathogens, altering exposure of persons to naturally occurring agents, or to increasing host tolerance to prevalent enteropathogens. A vaccine is feasible in the control of certain enteric infections among high risk groups: typhoid fever and cholera, in areas of hyperendemicity or during an epidemic, shigellosis in institutionalized populations that are at risk to develop illness due to known prevalent serotypes, enterotoxigenic Escherichia coli for US travelers to Latin America, and perhaps rotavirus for all children under 3 years of age. In diarrhea, the most useful form of treatment is an oral glucose/electrolyte solution, which in most cases will prevent dehydration. Lactose containing foods should be removed from the diet early in the course of diarrhea. Antimicrobial agents are necessary in the treatment of typhoid fever, are useful in the treatment of shigellosis, giardiasis, and amebiasis, and are contraindicated in intestinal salmonellosis.

Antidiarrheals↗

[Clinical problems of amebiasis].

Dagnostic and therapeutic problems of amebiaiss, a disease rarely observed in this country, are discussed in the light of four own cases representing the various courses of the disease. These observations prompt the following conclusions: 1. Amebiasis should be considered in cases of unclear acute or chronic intestinal disease, even if the patient has never visited endemic regions. 2. Non-tropical forms of amebiasis may follow a severe course with complications such as liver abscess or ameboma. 3. The advice of a specialized laboratory is necessary for stool examinations on amebae. 4. Stool examinations for amebiasis should be combined with serological tests. The immunofluorescense test is of special value. False negative results are however possible, especially in cases without tissue inflitration where the infection is limited to the intestinal lumen. 5. Metronidazol (Flagyl) greatly simplifies the treatment of amebiasis as it is both efffective and better tolerated than most other antiamebic agents.

Adult↗