Initial Workup: If blood diarrhea or >6 stools/day and febrile then consider stool cultures, fecal leukocytes, electrolytes.
Isolation: Contact precautions for diapered or incontinent children.
Suspect if blood diarrhea, cramping develop with recent antibiotic exposure.
Suspect if prominent abdominal pain. Young infants may only have bloody diarrhea. Can have immunoreactive complications such as AIDP, reactive arthritis, Reiter syndrome or erythema nodosum.
E. coli O157:H7
(Enterotoxin producing, ETEC)
May cause asymptomatic disease, gastroenteritis, bacteremia, osteomyelitis or meningitis. Exposures to lizards and other reptiles may result in unusual species of Salmonella.
Suspect if fever, cramps, tenesmus, abdominal pain. Complications include seizures, bacteremia, Reiter Syndrome, HUS (S. dystenteriae;type 1), toxic megacolon and toxic encephalopathy (ekiri syndrome).
Bacteremia in 30-50% of cases. Definitive antimicrobial therapy based on culture results. B. fragilis invades gut after several days of age.
Consider adding cefotaxime if CNS involvement cannot be excluded. Consider replacing ampicillin with vancomycin if MRSA/CONS. Consider adding clindamycin if perforation cannot be excluded.
Pediatric antibiotics
OB/GYN antibiotics
Skin and soft tissue antibiotics
Newborn resuscitation
Post exposure prophylaxis antibiotics
Baby feeding and nutrition
Sepsis antibiotics
Neuro antibiotics