Shigellosis

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1. symptoms

    1. Abdominal pain

    2. 70% mucosal diarrhea

    3. 40% bloody diarrhea

    4. N/V

    5. 30% fever

    6. at first diarrhea is watery and massive but then became bloody but more frequent

2. Dx: S/E, Leukocyte and PMN in stool

3. Treatment

    1. Syrup azithromycin first day 12mg/kg/day then 6mg/kg/day for 4 days

        1. or Amp ceftriaxone 50mg/kg/dose IV SD

        2. or Syrup cefixime 8mg/kg/day (syrup 100mg/5ml)

        3. or Tab ciprofloxacin 500mg bid for 5 days

    2. Syrup zinc sulfate bid

        1. 2.5 cc for <6m/o

        2. 5 cc for >6m/o

    3. Powder ORS

    4. Syrup acetaminophen 10mg/kg 120mg/5ml w/2 cc qid

4. in case of failure of treatment

    1. Metronidazole 20mg/kg/day tds