Recently, City Children’s Hospital received children DTM Th. female, 3 months old, living in Kien Giang, was referred by a local hospital with a diagnosis of infectious enteritis. Taking the child’s history recorded fever, loose black stools 2-3 times in 2 days.
Go to a private doctor to diagnose infectious diarrhea, treat for another 8 days, the child has no fever but still has black, liquid stools 3-4 times/day. The mother saw that the child’s skin and lips were pale, so she went to the district hospital for first aid, transferred to the provincial hospital. Here the child was diagnosed with infectious enteritis, gastrointestinal bleeding, treated for 7 more days with antibiotics, pink transfusion. settling demand. The condition of black stools is still there, vomiting a few times with green discharge, so the child should be transferred to the City Children’s Hospital in a state of rapid pulse rate 168 times/minute, mild, cool limbs, CRT ≥ 4 seconds, blood pressure difficult to measure, The heart is regular, the lungs are clear, the abdomen is soft, the skin is pale, the mucous membranes are pale, the Hct is only 14% (normal Hct at this age is 28-32%), diagnosed with gastrointestinal bleeding, enteritis, sepsis , anti-shock fluid therapy, blood transfusion, fresh frozen plasma, platelets, cryoprecipitate, antibiotics, hospital consultation: clinical hematology, general surgery, gastroenterology, imaging, diagnostics Diagnosis of persistent lower gastrointestinal bleeding, not ruled out due to meckel’s diverticulitis, suggested gastrointestinal endoscopy, exploratory laparoscopy, recorded flexible endoscopic tube through the mouth into the upper gastrointestinal tract, noted: esophagus , gastric aneurysm, body: normal mucosa, pylorus: mucosal congestive inflammation, duodenal bulb: mucosa with mild erosive inflammation, with many worms, duodenum D2: mucosal inflammation edematous, with many worms. Lower gastrointestinal endoscopy, recorded: anus, rectum: normal mucosa, sigmoid colon, left colon, transverse colon, right colon, cecum: normal mucosa, worms, terminal ileum colon, ileocecal valve: mucosal inflammation edema. Conclusion: edematous inflammation of gastric mucosa – duodenum – terminal ileum, worm infection.
The child was transferred to the ICU for continued treatment of respiratory support, circulatory support, blood transfusion, blood products, antibiotics, vitamin K1, and anthelmintic albendazole. Results after more than 1 week of treatment, the child was awake, ruddy, no gastrointestinal bleeding, weaned from the ventilator and suckled quite well.
Through exploitation and asking carefully about how to raise children, it is known that children are fed with alkaline river water, not boiled, so worm eggs are suspected from here. Therefore, parents should take care of their children carefully, eat well, drink mainly, wash their hands when preparing food, hygiene, … to ensure that children are not infected with bacteria, parasites, …
Doctor 2 Nguyen Minh Tien
City Children’s Hospital