SALMONELLA TYPHI AND CHRONIC
ABDOMINAL PAIN
CHILDREN.
IN
BY:PROF DR:
OSAMA ELFIKY
CHRONIC ABDOMINAL PAIN: •
-Pain lasting two weeks or longer it may •
Be persistent or recurrent.
. •
Abdominal pain appears to account for up to
4percent of all pediatric office visits .
Some studies suggest that 13percent of middle
school students and 17percent of high school
students experince weekly attacks of
abdominal pain .
.
CAUSES OF CHRONIC
ABDOMINAL PAIN.
THE COMONEST CAUSES INCLUDE: •
Renal calculi. •
Chronic appendicits. •
Chronic cholycstitis. •
Chronic hepatitis. •
Chronic pancreatitis. •
IntestinalT.B. •
Parasitic infestations. •
Ulcerative colitis. •
Famelial meditrranian fever. •
Lead poisining. •
Porphyria. •
GIT infections as salonellosis. •
SALMONELLA ENTERRICA
Salmonellae are gram-negative motile •
bacilli. They belong to the family
Enterobacteriaceae.
Saalmonellae are potential enteric •
pathogenes leading to food born
Illness. •
DISEASES CAUSED BY
SALMONELAA
Typhoid fever. •
Bacteremia. •
Enterocolitis •
Focal infections as osteomylitis. •
Abdominal pain is a common feature of •
typhoid fever.Now how can salmonella
Causes chronic abdominal pain? •
This may be due to one of the following: •
1-Diagnosis of typhoid fever may be •
missed due to the non specific
Features as diarrhea,vomitting or •
Predominant respiratory symptoms. •
Chronicity may be due to short
•
Course of antibiotics with use of
•
Low dosage .
•
2-Salmonella typhi colonizes the gall •
Bladder and billiary tree and spreads •
To the intrahepatic bile ducts.
•
Because salmonella is one of the causes •
Of chronic abdominal pain astudy was
•
Carried out by us to evaluate the •
magnitude of this problem in Benha
univerisity hospital pediatric department.In
the priod from jauary 2010 to january2011.
200 children of both sexes their mean age •
was {9.2years} complaining of chronic
Abdominal pain were enrolled in this •
Study.Those chidren were subjected •
To thourghu history taking,comlete •
•
•
Clinical examination and investigations •
In the form of :
•
Complete urine and stool analysis
•
Complete blood picture and CRP.
•
Widal test and salmonella IGM.
•
Abdominal sonography.
•
Results of our study revealed that Ascaris •
was present in 18{ 9%}of cases,Ent.cyst
in 59{29.5%},Giardia in 11{5.5%} of cases
H.nana in 11{5.5%} of cases,Oxyuris in •
14{7%} of cases,Renal gravels in
13{6.5%},Stone kideny in 3{1.5%} of cases
Chronic calcular cholycystits 8{4%} of •
cases and finally 29{14.5%}of cases were
prooved to have salmonellosis by
salmonella IGM.
From the previous results it is evident that
Salmonellosis comes the second in order
Of occurence preeceding other causes of
abdominal pain which we think that they
Are more prevelant such as giardiasis,
ascaris,oxyuris or H.nana.
We observed in our study that cases •
having salmonellosis and other parasitic
Diseases suffered abdominal pain after •
Receving antiparasitic medications. •
Their pain was curred after they received •
The specific treatment for salmonellosis. •
Accoringly we reccomend: •
1-Proper dignosis and treatment of •
Febrile ilnesses of chldren if there is •
Suspecition of salmonella infection •
To avoid development of chronicity and •
carrier state .
2-National wide epidemiolgical studies •
To evaluate the magnetud of the problem. •
3-These studies must involve carier •
detection espicially among food handelers.
4-Trceing sources of infetions as •
contminated water supplay and foods
As beef, poultary,eggs and milk products. •
5-Vaccination of high risk population as •
food handelers.
THANK YOU. •