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Fever, nausea, stomach pain and stool mixed with blood. Could this be amoebiasis infection?
Question: Related to the previous question about using combination therapy of Metronidazole and Cotrimoxazole. Here is the case : a 13 years old boy complaining about having fever 38,5-39 C and nausea for the first day then reduce by the 2nd day but stomach pain and Äiarrhoe mix with bood (picture attached) start to occured about 10 times. Do you agree this due to an amoebiasis infection. ? what is your opinion. and what is the best. management ? Dr. XXXXXXX XXXX. I am a GP.
Brief Answer: hospitalise, monitoring, hydration & management Detailed Answer: Hi, Thanks for writing in to XXXXXXX I have read the history and seen the attached photo showing stool mixed with blood. Producing 10 blood mixed stool is a serious issue particularly with high grade fever and pain abdomen. It can be anything a bacillary dysentry, amoebiasis, ischemic insult to bowel to name a few. Ideally the child muat be hospitalised and managed. Today's pathogenic bacilli are resistent cotrimoxazole so better not to go for it. I would advise to treat the child inpatient basis. Monitor vitals, urine output hourly, ensure hydration and temperature control. Gie curd based and sweetened rice diet if he can take orally. I would advise ro send Complete blood counts, renal function tests and cultures of blood and stool. Also get stool microscopic examination for amoebiasis. The investigations should be sent before starting the antibiotics. Delay in treatment may lead to big complications. The antibiotics metronidazole plus levofloxacin/ceftriaxone in appropeiate doses all IV are need of the hour. I hope the advise will be helpful for you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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