A Case Of Severe Antibiotic-associated Diarrhea And Literature Review

Objective:To analyze the clinical characteristics and progress of diagnosis and treatment of antibiotic-associated diarrhea(AAD)in order to improve the understanding and diagnosis of AAD by clinicians.Methods:The pathogenesis,clinical manifestations,auxiliary examinations,diagnosis and treatment of a child with severe AAD were analyzed in detail,and the relevant literature was reviewed.Result: Fever occurred more than 20 days ago,no obvious improvement was observed after antibiotic treatment,and diarrhea occurred.For yellow-green water-like stool with mucus,a variety of antibiotics were used successively to treat diarrhea.Diarrhea improved slightly and the body temperature was repeated again.The patient was treated in our hospital.The skin was scattered in rash,the blood routine showed high white blood cell count,high infection index,white blood cells in urine and stool routine were visible.Ropenem anti-infective treatment,the symptoms of children did not improve,check the return with pneumonia,pleural effusion,pericardial effusion,etc.,empirical treatment of norvancomycin anti-coccal infection,fecal Enterococcus infection,drug sensitivity showed that vancomycin sensitive,after treatment,children’s body temperature was stable,stool and chest CT,cardiac ultrasound returned to normal,leukocyte count,erythrocyte sedimentation rate,CRP slightly higher.The patients were discharged from hospital by taking linezolid orally,and the above indicators were reviewed regularly.Conclusion: AAD is caused by the disruption of normal intestinal flora balance,weakened intestinal function and diarrhea caused by the toxic and side effects of antibiotics in the treatment of primary diseases.It is related to the types of antibiotics,the long time of application and the low resistance of children.We should pay more attention to conditional pathogens.Rational use of antibiotics is the key.Preventive use of microecological agents is the key to correct AAD in time.The treatment of electrolyte disorder,zinc supplementation and rational selection of sensitive antibiotics based on clinical manifestations and laboratory tests of children can achieve good therapeutic effect.