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An 18-month-old child presents to the emergency center having had a brief, generalized tonic-clonic seizure. He is now postictal and has a temperature of 40°C (104°F). During the lumbar puncture (which ultimately proves to be normal), he has a large, watery stool that has both blood and mucus in it. Which of the following is the most likely diagnosis in this patient?
1. Salmonella
2. Enterovirus
3. Rotavirus
4. Campylobacter
5. Shigella
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3) isn't rotavirus most common in babies/kids less than 5
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rotavirus doesn't cause bloody diarrhea
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opps my bad! I overlooked the bloody part-
then its shigella for the high fever and bloody diarrhea
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4......(5 willbe small amont
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The answer is e, Shigella.
Clinical manifestations of shigellosis range from watery stools for several days to severe infection, with high fever, abdominal pain, and generalized seizures. In general, about 50% of these children have emesis, greater than two-thirds have fever, 10 to 35% have seizures, and 40% have blood in their stool. Often, the seizure precedes diarrhea and is the complaint that brings the family to the physician. Fever usually lasts about 72 h, and the diarrhea resolves within 1 to 2 weeks. Presumptive diagnosis can be made on the clinical history; confirmation is through stool culture. Supportive care, including adequate fluid and electrolyte support, is the mainstay of therapy. Antibiotic treatment is problematic; resistance to trimethoprim-sulfamethoxazole and ampicillin is common, necessitating therapy with third-generation cephalosporins in many cases.
