Abstract
18 children who fullfilled the criteria of chronic non-specific diarrhea of infancy were evaluated for intestinal bacterial overgrowth as a cause of their diarrhea. The children were randomized into group I (n=10), who were treated with trimethoprim-sulfamethoxazole (TMX) and group II (n=5>, three children were excluded because of Yersinia enterocolitica infection) treated with low lactose diet only. The aim of the study was to investigate whether colonization of the small intestine with upper respiratory tract microflora was related to the diarrhea and if treatment with TMX resolved the diarrhea.
METHODS. Stringtest (Enterotest PediatricR) was used to assess bacterial growth in duodenun. Duodenal fluid were cultured aerobically and anaerobically and examined directly for Giardia and Ameba. Stool was analyzed for pH, haemoglobin, chymotrypsin, Clostridium difficile toxin and direct microscopy for ova and cyst and aerobic and anaerobic bacterial cultures were performed.
RESULTS. In ten of eleven successfully investigated children we found bacterial overgrowth of the small intestine (>105cfu/ml) with upper respiratory tract microflora. Alpha haemolytic streptococci dominated in all but one string. In nine of ten children in group I the diarrhea resolved immediately while the diarrhea persisted in all children in group II. All children i both groups had adequate calorie and fat intake.
CONCLUSIONS. The results indicate that bacterial overgrowth of the small intestine rtith upper respiratory tract microflora may be a cause of chronic non-specific diarrhea and that this diarrhea can be treated successfully with TMK.
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Dahlström, K., Danielsson, L. & Kalin, M. 71. CHRONIC NON-SPECIFIC DIARRHEA OF INFANCY-SUCCESSFULLY TREATED WITH TRIMETHOPRIM-SULFAMETHOXAZOLE. Pediatr Res 22, 108 (1987). https://doi.org/10.1203/00006450-198707000-00092
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DOI: https://doi.org/10.1203/00006450-198707000-00092