Acute gastroenteritis
Diarrhea is quite common in HIV infected children. Dehydration is a common cause of mortality and morbidity. Thus one should assess dehydration and base management considering special types of Diarrhea diseases. Rehydration should be based on WHO protocol and part of the IMNCI programme.
Children with severe dehydration should be referred to the hospital immediately.
Patients with following danger signs should be hospitalized:
- Infants under 1 month of age
- Malnourished children
- Convulsions
- Altered sensorium
- Persistent vomiting
- Respiratory distress
- Persistent Diarrhea with dehydration
- Hypothermia
- Abdominal distension
- Dysentery in a child < 12 months of age.
Pre-referral treatment as per IMNCI including first dose of antibiotic and rehydration should be started prior to referral.
Dysentery
Dysentery presents with blood in stool with or without mucus.
Patient should be hospitalized if
- Child is dehydrated
- Child is less than 12 months of age
- No improvement after 2 days of antibiotics
- Child’s condition is worsening
Hospital management
Ceftriaxone – 100 mg/kg/day IV for 3 to 5 days in BD doses
OR
Amikacin – 15 mg/kg/day IV for 3 to 5 day in BD doses
Out-patient management
Antibiotics as per IMCI programme and correction of dehydration.
- Educate family on hygiene
- Send stools for microscopy and culture.