The management of acute bloody diarrhoea potentially caused by vero cytotoxin producing Escherichia coli in children
Acute bloody diarrhoea in children is rare and is commonly associated with intestinal infections, especially vero cytotoxin-producing Escherichia coli (VTEC) and Campylobacter species. Urgent advice should be sought from a paediatric specialist whenever a child up to the age of 16 years of age presents at primary care, or an emergency department, having suffered a single acute episode of bloody diarrhoea. This is to ensure that a prompt diagnosis is made, including consideration of infection by VTEC, and other serious treatable disorders. Prompt management, including good infection control procedures, will help to ensure that the risk of further spread of disease is minimised if VTEC is present. Clinicians should have a high index of suspicion that VTEC infection is present where the patient has been in recent close contact with: - ruminant animals (principally cattle, goats, sheep), their faeces, and faecally contaminated environments (such as at open farm visits) - where there has been contact with another known or suspected case of VTEC - where an outbreak of VTEC infection is known, or suspected, to be present locally Where VTEC infection is considered in the differential diagnosis, clinicians should be mindful of the potential contraindications concerning the use of anti-motility drugs and certain analgesics. Active fluid resuscitation should be used and specialist guidance sought before initiating antibiotic treatment.