Enteroinvasive escherichiosis in children: causes, symptoms, diagnosis, treatment

Enteroinvasive escherichiosis is observed mainly in children older than 3 years and in adults. Leading serovars: 0124 and 0151, less often - 025, 028, 032, 0112, 0115, 0129, 0135, 0136, 0143, 0144, 0152.

Escherichia of this group are able to penetrate the epitheliocytes of the large intestine and multiply in them (intracellularly). Many serovars have antigenic kinship with Shigella on O-antigen and with Klebsiella pneumonia on K-antigen.

ICD-10 code

A04.2 Enteroinvasive infection caused by Escherichia coli.

Epidemiology

Infection often occurs by the food path, but a waterway of infection is also possible. The disease occurs in the form of both sporadic cases and group epidemics (as in shigellosis), mainly in the summer-autumn period.

Pathogenesis of enteroinvasive escherichiosis

Enteroinvazivnye escherichia live and multiply mainly in the large intestine and cause "dysentery-like" diseases with a similar pathogenesis and interaction with the intestinal epithelium.

Symptoms of enteroinvasive escherichiosis

The incubation period of enteroinvasive escherichiosis is usually 1-3 days. The disease begins, as a rule, acute, with the rise in body temperature, headache, nausea. Often - vomiting, moderate pain in the abdomen. At the same time or a few hours later, a loose stool with pathological impurities appears. Symptoms of intoxication are definable only in the first 1-2 days of the disease (maximum 3 days). The general condition of the patient is negligible, hyperthermia syndrome (as in shigellosis) does not happen. Moderate fever no more than 1-3 days.

When palpating the abdomen, rumbling and soreness is first seen throughout the abdomen, and then primarily along the colon. The sigmoid colon is palpated in the form of spasmodic, moderately infiltrated and painful striae. The anus will be closed, tenesmus. As a rule, does not happen. The chair is most often feces, up to 3-5 times a day, less often up to 7-10 times. With an admixture of turbid mucus, sometimes - greens and blood veins. Unlike shigellosis, there is usually no admixture of pus, feces are not severe. The disease quickly ends: the body temperature drops to normal after 2-3 days, the clinical manifestations of intoxication disappear, and on the 3-5th day the stool is normalized.

According to the nature of the current, enteroinvasive escherichiosis is practically indistinguishable from the light and medium-sized forms of shigellosis. Etiological diagnosis can be established only on the basis of the results of laboratory research methods.

Treatment and prevention of enteroinvasive escherichiosis

Same as shigellosis.

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