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Dr. Andrew Rynne

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What are the chances of cross infection to twin with bacillary dysentry?

Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 7288 Questions

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Posted on Mon, 1 Sep 2014 in Child Health
Question: my one month old baby had bacillary dysentry last week she is recovering on oral ofloxacin and probiotics when should i repeat the stool test or how can i confirm that she is fully recoverd she had 2 plus mucus no blood and 10 to 15 pus cells per hpf in test and was diagnosed as bacillary dysentry pls give full information ......now its 10 th day she is passing yellow grain like stools AROUND 10 ML WATERY ,,frequency 5 per day ,, ....sucking well ,,,urinating well ,, no fever/no vomitting every time she urinates she speckles a bit stools is this normal, is child recovering pls help me out theres other twin baby help me to prevent cross infection
doctor
Answered by Dr. Sumanth Amperayani 20 minutes later
Brief Answer:
Recovering viral diarrhea/ Gastrocolic reflux

Detailed Answer:
Hi...we should call it a bacillary dysentery only if there is blood in the stools. if it is not so, the possibilities are viral diarrhea or a gastrocolic reflux. Will explain you about both -

Viral diarrhea -
Once it starts it will take 5-7 days to completely get better. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.
There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen if unnecessarily used causing antibiotic associated diarrhoea.
I suggest you use zinc supplements (Z&D drops 1ml once daily for 14 days) & ORS (Each small packet mixed in 200ml of potable water and keep giving sip by sip) as hydration is very important and crucial part of treatment.

Gastrocolic reflux -
It is quite common for babies of this age group t pass small amount of diarrhea or loose stools soon after feeds. This need not be treated as diarrhea and especially antibiotics are not indicated. Once the stomach expands after feeds - the contraction which follows will proceed down the gut till some stools which is there in the rectum is expelled out.
Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.

Some suggestions - am surprised that for a 1 month old baby a diagnosis of bacillary dysentery is made and antibiotics were used. It is extremely rare and I seriously doubt the diagnosis.

AS I DON'T THINK THIS IS AN INFECTION THERE IS NO CROSS INFECTION AT ALL. But as you have specifically asked for it - the best way is to wash hands with chlorhexidine solutoin before handling another baby. That is hand washing is a must before touching the babies and all the utensils used to feed the babies have to be segregated.
Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on Health care magic are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health.
Dr. Sumanth MBBS., DCH., DNB (Paed).,

Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Sumanth Amperayani 3 hours later
Ok sir then 2 plus mucus in stool analysis that we did is it because of viral infection I read in net this not possible pls sort it out .. anyhow we stopped antibiotics zinc we r giving ...stools are yellow grainy little watery frequency 5 per day but my worry is everytime she passes urine she passes scanty amount of stools or dripples is that ok and paediatrician in follow up told hydration better weight gain is ok no need of ors should I repeat stool test and one thing I forgot stool culture showed normal intestinal flora ..normal stools pictures I saw in net it resembles same as my baby's but every time she urinates she dripples little stools is that ok and antibiotics we stopped yesterday should we continue probiotics
doctor
Answered by Dr. Sumanth Amperayani 2 hours later
Brief Answer:
Suggestions on diarrhoea

Detailed Answer:
Hi...coming to your queries one by one -
1. Mucus can be present in viral diarrhoea too. Just because of mucus, it doesn't mean that it is bacillary or bacterial dysentery or infection.
2. Passing of scanty stools every time the baby passes urine and vice versa is quite common in this age group. Don't worry if the baby is active.
3. You need not repeat any stool test.
4. Stool culture is not necessary at this juncture and any how the culture already done is showing normal intestinal flora- which means it doesn't require any treatment.
5. You can continue probiotics for a total of 5 days and stop.

I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Sumanth Amperayani 16 hours later
Ok Sir thanks a lot ..my last question consistency of stool is little watery always with yellow grains like 4 episodes per day is that ok and can I take her for dpt shot next week
doctor
Answered by Dr. Sumanth Amperayani 22 minutes later
Brief Answer:
That is ok and you can give the shot

Detailed Answer:
Hi...I am happy that my suggestions put you at ease.

The consistency and frequency of the stool doesn't matter as far as the baby is gaining weight and feeding well. So do not worry.

Yes, you can go ahead and give the shot. Loose stools are never a contraindication for giving a DPT shot.

I wish your kid a very bright future.. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Sumanth Amperayani 20 hours later
My one month old baby was recovering from diarrhea till yesterday she was passing yellow grainy little watery today she passed more green stools watery with yellow grains we r really worried pls help I need paediatrician to answer this
doctor
Answered by Dr. Sumanth Amperayani 18 minutes later
Brief Answer:
Number of stools doesn't matter if kid is active

Detailed Answer:
Hello XXXXXXX I am a practising pediatrician and I can tell you - the number of stools doesn't really matter as is the consistency of the stool. As long as the child is active and urinating well you need not worry about the number of stools and the liquid consistency.

As I have already mentioned please keep giving the kid breastfeeds and z and d drops 0.5 ml once daily.

It is usual for the diarrhoea to increase in number of stools when the child is recovering from it. So I again urge you not to worry. If you feel the kid is not active or if the urine output has come down I suggest you see a pediatrician to check if the child has got dehydration.

Regards
Dr Sumanth
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sumanth Amperayani 59 minutes later
Sir today she passed full greenish stools with yellow speckles I was Convinced with ur yesterday answer but today she passed dark greenish stools is infection flaring up or its normal pls green stools give explaination till yesterday it was yellow grainy this is 13 th day of diarrhoea is she recovering or getting worse
doctor
Answered by Dr. Sumanth Amperayani 6 hours later
Brief Answer:
Color of stools doesn't matter - She is recovering

Detailed Answer:
Hello XXXXXXX

Thanks for your trust in me.

The color of the stools is really not important. It will be important only if there is blood in the stools. As I have mentioned in my 1st reply to you - There is no need to use antibiotics unless there is blood in the motion. Antibiotics might worsen and prolong the duration of the diarrhoea if unnecessarily used causing antibiotic associated diarrhoea.

I think this is antibiotic associated diarrhea and will take more than 2 weeks to settle.

If I was there treating your kid, I would have started probiotics and this your kid is already on. You mentioned about color of the stools but I again reiterate the fact that if the kid is active otherwise and passing urine normally and there is no blood in the stools - please do not worry.

Please get back if you have any doubts. I am open for discussion. You seem to be very worried, but I urge to maintain calm and your kid will be normal in due course please.
Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Sumanth Amperayani 3 days later
sir as i am MBBS doctor i am putting forth a doubt here my baby having loose stools for 17 th day now till now no ors used baby active gaining weight Q 1] is she loosing much electrolytes in watery stools she is having ? is it similar to secretory diarrhoea ? dr told me it is transitional diarrhea of new born and no ors reqd Q 2 ] is that electrolytes replaced by breast milk alone ? Q3 ] should i give mother ors for proper supply of electrolytes through breast milk because potassium sources we are not sure she is taking Q 4 ] or else is it safe and good to give some ors to baby to prevent possible dehydration Q 5 ] how long will my baby take to recover maximum ? pls dont get irritated sir we are having twins i dont want my baby to get admitted one baby in hospital one baby at home tuf situation to face pls tell me about transitional diarrhoea
doctor
Answered by Dr. Sumanth Amperayani 1 hour later
Brief Answer:
Suggestions on Diarrhoea

Detailed Answer:
Hello Dr XXXXXXX

I never get angry/ irritated with any of my patients questions even if they ask 1000 as I myself am a parent and I understand your concerns fully.

Coming to your queries -
1. Small amount of diarrhoea will not need ORS/ There will not be much of electrolyte loss requiring replacement - your doctor is right.
2. This is not secretory diarrhoea
3. Brest milk alone is enough ans also the best
4. No need to give mother ORS for baby's diarrhoea.
5. Don't give ORS unless the baby is loosing weight due to diarrhoea.
6. It might take few weeks to recover. Unless the kid's having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry.
7. There is no need t admit.

Hope I have addressed your concerns. I reiterate the fact that I am ready answer and counsel you a 100 times without irritation. Please feel free to ask and interact.

Regards - Dr. Sumanth


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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