Dysentery in Hospitalized Children- a Single Center study

Introduction: Dysentery is a common etiology for hospitalization in children.
We set to characterize the clinical presentation and laboratory results associated with
different pathogenic agents in children hospitalized for dysentery in our hospital.

Methods: A retrospective study of all children hospitalized for clinical dysentery
January 2016 to December 2019. Clinical and laboratory data was compared between
different pathogens. Risk factors for accompanying convulsions were assessed.

Results: 1170 children were hospitalized with acute gastroenteritis. 137, 89
(65%) males, were diagnosed with dysentery, at a median age of 3.7 (IQR- 1.5-8.2)
years. Stool cultures identified Campylobacter (44, 32.6%), Shigella Sonnei (27,
20%), non-typhoidal Salmonella (18, 13.3%), Enteropathogenic-E. Coli (12, 8.9%)
and were negative in 34 (25.2%). A single (0.7%) Campylobacter was resistant to
erythromycin, and a single (0.7%) E.Coli was resistant to ceftriaxone. Patients with
Campylobacter presented less often with vomiting- 22 (56.4%) vs. 25 (92.6%) vs. 14
(77.8%) vs. 10 (83.3%) vs. 26 (78.8%), p=0.015; and had lower maximal white blood
cell count- 9.75 vs. 13.9 vs. 10.7 vs. 15.4 vs. 12.0 x10 9 /µL, p= 0.036, respectively.
Eleven (8%) patients presented with seizure, 10 (90.9%) at the 1-5 years’ age group,
and one (9.1%) older child, pmedian of 39.9 vs. 39.0 °C, with odds ratio of 1.88, p=0.04. Median hospitalization
was 3 days irrespective of causative pathogen.

Conclusions: Clinical presentation and laboratory results are not sufficient to
predict the causative bacteria in dysentery. Despite common use, ceftriaxone and
azythromycin maintain efficacy for dysentery.