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Mucoid presentation of acute enterocolitis in children: a hospital-based case-control study
1Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, Calcutta, India. icmrnicd@ren.nic.in
Abstract:
A hospital-based case-control study was carried out to clarify the characteristics of mucoid presentation of acute enterocolitis in children. One hundred sixty-eight cases of acute mucoid enterocolitis (study population) were compared with 200 cases of watery diarrhoea and 118 cases of blood dysentery (control groups) on the basis of clinical characteristics and findings on stool examination. Study and control groups were comparable with respect to age, body weight and nutritional status. There was no significant difference in clinical characteristics (duration of diarrhoea, stool frequency, presence of vomiting, fever and dehydration) between patients suffering from mucoid enterocolitis and blood dysentery. However, watery diarrhoea patients had significantly high frequencies of vomiting (p=0.00001) and dehydration (p=0.00001). High numbers of microscopic red blood cells (mean +/- SD: 40.8 +/- 16.8) and white blood cells (40.6 +/- 18.0) were present in faecal samples of the patients with mucoid enterocolitis, which is indicative of infection caused by enteroinvasive enteropathogens. Shigella was a commonly identified enteropathogen in patients with mucoid enterocolitis (40.5%) and in patients with dysentery (46.6%), with no statistically significant difference (p = 0.30). Isolation of Salmonella was statistically similar in study and control groups. However, Entamoeba histolytica was detected in significantly high frequency in patients with mucoid enterocolitis as compared to the patients with dysentery (p = 0.0004) and watery diarrhoea (p = 0.00004). Our results indicate that mucoid enterocolitis patients are infected with enteroinvasive enteropathogens, and that stool examination is useful in establishing the aetiological diagnosis.
Insights
Acute mucoid enterocolitis in children is linked to enteroinvasive pathogens, with stool examination aiding diagnosis. This contrasts with watery diarrhea, which shows higher rates of vomiting and dehydration.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Mucoid enterocolitis is a distinct clinical presentation of acute diarrhea in children.
- Understanding the etiological agents and clinical features is crucial for effective management.
Purpose of the Study:
- To characterize acute mucoid enterocolitis in children.
- To compare its clinical presentation and etiological agents with watery diarrhea and blood dysentery.
Main Methods:
- A hospital-based case-control study involving 168 cases of mucoid enterocolitis and control groups (200 watery diarrhea, 118 blood dysentery).
- Clinical characteristics and stool examination findings were analyzed.
- Enteropathogens including Shigella, Salmonella, and Entamoeba histolytica were identified.
Main Results:
- Mucoid enterocolitis shares clinical features with blood dysentery but differs significantly from watery diarrhea in vomiting and dehydration rates.
- Stool examination revealed high levels of red and white blood cells in mucoid enterocolitis cases.
- Entamoeba histolytica was significantly more prevalent in mucoid enterocolitis compared to other diarrhea types.
Conclusions:
- Mucoid enterocolitis in children is associated with enteroinvasive enteropathogens.
- Stool examination is a valuable tool for identifying the cause of mucoid enterocolitis.
- Distinguishing mucoid enterocolitis from other diarrheal diseases is important for targeted treatment.