food poisoning in children

Introduction

Introduction to Pediatric Food Poisoning Ingestion of poisoning caused by bacteria, bacterial toxins, fungi, poisons or foods containing toxic substances is a common clinical emergency. Serious complications often occur in children with various complications. Mainly gastrointestinal symptoms, such as nausea, vomiting, abdominal pain, diarrhea, etc., severe cases may have dehydration, acidosis, and even shock, coma, often have fever. The poisoning caused by different bacteria has its own clinical characteristics. basic knowledge The proportion of illness: 0.02% Susceptible people: children Mode of infection: non-infectious Complications: dehydration shock, coma

Cause

Pediatric food poisoning cause

Bacterial food poisoning (20%):

Food is contaminated by bacteria and its toxins during production, storage, transportation and sale. Common bacteria include Salmonella, Escherichia coli, Escherichia coli, halophilic bacteria, and other bacteria, such as Staphylococcus aureus. After contaminating foods such as botulinum and streptococci, they are proliferated in food, releasing toxins and being absorbed by the intestines, causing poisoning. Bacterial exotoxin can kill bacteria after high temperature treatment, but the toxins are not destroyed and can be poisoned after ingestion. .

Fungal food poisoning (20%):

Refers to poisonous fungi, such as Gibberella, Penicillium and Aspergillus, causing poisoning caused by contaminated food. Fungal poisoning usually has gastrointestinal symptoms first, followed by liver, kidney damage or neurological symptoms.

Toxic, plant poisoning (25%):

The food itself is poisonous, such as puffer fish, cockroaches, poisonous cockroaches, cassava, ginkgo and germinated potatoes themselves are poisonous and poisoning occurs after eating.

Chemical food poisoning (15%):

The food is doped with some heavy metals, and organic phosphorus causes poisoning.

Pathogenesis

1. Direct action of poisons: Toxic substances can directly cause various organ dysfunction, central nervous system function inhibition, brain edema, renal insufficiency, hemolysis, multiple system damage or multiple organ dysfunction syndrome (MODS). Even circulatory failure, respiratory muscle paralysis causes respiratory failure, multiple organ failure (MOF) or sudden death.

2. Many secondary or indirect factors involved in tissue and organ damage include systemic inflammatory response syndrome (SIRS), free radical damage, microcirculatory disorders, secondary infections, and internal environment disorders.

Prevention

Pediatric food poisoning prevention

(1) Do not eat food that is not fresh and spoiled, and does not eat seafood that is prohibited from being listed by the health department.

(2) The vegetables that are bought should be soaked in clean water for half an hour or more, and the water should be changed several times to be cleaned to prevent the pesticide from harming the body.

(3) Educate children not to buy food at unlicensed vendors, and do not buy canned foods and other packaged foods that have no trademarks or no date of manufacture, no production units, no warranty period, and other trademarks that do not meet the specifications.

(4) The raw and cooked foods should be separated, and the tools (knives, chopping boards, crepe cloths, etc.) should be cooked and separated separately, so that the tableware should be cleaned in time, and the disinfection conditions should be disinfected frequently.

Complication

Pediatric food poisoning complications Complications dehydration shock coma

In severe cases, there may be dehydration, acidosis, and even shock and coma. Botox poisoning can cause blindness, difficulty swallowing and breathing, and death from respiratory paralysis. Fungi can cause liver and kidney damage, convulsions, neutropenia, thrombocytopenia, and the like. Arrhythmia, pulmonary edema, convulsions and even coma, if not rescued in time, can be life-threatening severe diarrhea can lead to dehydration, accompanied by hoarseness and muscle spasm, there is a disturbance of consciousness.

Symptom

Pediatric food poisoning symptoms Common symptoms Gastrointestinal symptoms, weakness, nausea, diarrhea, thin stool, fatigue, dizziness, abdominal pain, coma, dizziness

More common in summer and autumn, the onset is urgent, often several people or dozens of people at the same time, the symptoms are similar, mainly gastrointestinal symptoms, such as nausea, vomiting, abdominal pain, diarrhea, etc., severe cases may have dehydration, acidosis, and even shock , coma, often fever, clinical symptoms caused by different bacteria:

1. Salmonella poisoning

Mostly caused by carnivorous or internal organs, especially dead animals, the incubation period is 6 ~ 24h, the longest can be 2 ~ 3 days, fever, headache, nausea, vomiting, diarrhea, general malaise, may be associated with rash, stool with pus, the course of disease 1 to 3 weeks, can die.

2. Staphylococcal poisoning

Leftovers, contaminated meat, milk, eggs caused by food, the incubation period is short, generally 3h, showing spit, diarrhea, mainly spit, fever is not obvious.

3. Halophilic poisoning

Caused by sea food or salted food, the incubation period is 8 to 12 hours, abdominal pain, diarrhea with vomiting, moderate fever, stool is washed water or pus and blood.

4. Botox poisoning

Botox is an anaerobic bacterium, mostly caused by expired canned food, sausage or confined storage food. The incubation period is from 1 day to several days. The nervous system has obvious symptoms, headache, dizziness, dilated pupil, weakness, eyelid drooping, double vision, Blurred vision, even blindness, difficulty swallowing and breathing, aphasia, death from paralysis due to breathing.

5. Escherichia coli

The incubation period is short, generally 4 to 12 hours, the symptoms are mild, mainly diarrhea, stool smells, rarely fever.

6. Fungi

Generally, there are gastrointestinal symptoms first, followed by liver, kidney damage or nervous system symptoms such as headache, dizziness, irritability, convulsions, coma, some fungi causing neutropenia or deficiency, thrombocytopenia, etc.

Examine

Pediatric food poisoning check

The vomit or stool culture may have bacteria or fungi. When botulism is poisoned, the extract of the suspected food is injected into the mouse or guinea pig. For example, the exotoxin containing botulinum bacilli rapidly smashes and dies; the food leaching solution is heated at 100 ° C. After 30 minutes, do the same experiment, and the animals are not dead, as evidenced.

Auxiliary examinations provide less evidence of direct poisoning.

1. X-ray examination: Partial poisoning can be diagnosed by X-ray photograph or understand the complications after poisoning.

2. Electrocardiogram, EEG, etc. Checking ECG, EEG and other auxiliary examinations can be used as reference indicators for judging the condition and prognosis.

Diagnosis

Diagnosis and diagnosis of pediatric food poisoning

diagnosis

1. Epidemiological data: There is a history of eating unclean food, while the eaters have the same or simultaneous onset, the symptoms are similar.

2. Main gastrointestinal symptoms: nausea, vomiting, diarrhea or abdominal pain, sometimes accompanied by fever.

3. The stool is loose: there may be mucus, pus and blood, and there is a stench.

4. Severe vomiting and diarrhea: dehydration and acidosis may occur.

Differential diagnosis

To identify the types of poisons, first find the source of the poison, make clear ingredients for the suspicious food, analyze the suspected food as much as possible, and combine the clinical symptoms, signs, stomach contents, and excretion of the excreted toxic substances to identify the differential diagnosis as soon as possible.

Non-bacterial food poisoning, such as germinated potato, Xanthium, bitter almond, puffer fish or poisonous cockroaches, the incubation period is only a few minutes to several hours, generally no fever, mainly vomiting, abdominal pain, less diarrhea, However, the neurological symptoms are more obvious, the mortality rate is higher, the mercury and arsenic poisoning patients have sore throat, congestion, blood in the vomiting and diarrhea, chemical analysis can determine the cause, cholera and parasitic disorder is painless vomiting, vomiting and vomiting For many, and no fever, the stool is rice-like water, because the incubation period can be as long as 6 days, so it is rare for a large number of patients in the short-term, stool smear fluorescent antibody staining microscopy and culture to find Vibrio cholerae or Vibrio cholerae, Determine the diagnosis.

Occasionally, acute bacillary dysentery, food vomiting, usually vomiting, often fever, urgency and heavy, feces mixed with pus, lower abdominal and left lower abdomen tenderness, stool microscopic examination of red blood cells, pus cells and macrophages, stool About half of the dysentery bacilli growth, viral gastroenteritis, caused by a variety of viruses, characterized by acute enteritis, incubation period of 24-72 h, mainly manifested by fever, nausea, vomiting, abdominal distension, abdominal pain and diarrhea, drainage It can be loose, and people with severe vomiting and diarrhea can have water, electrolyte and acid-base balance disorder.

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