Clinical manifestation of enteritis in children.

Purpose: Timely antibiotic therapy in selected cases of diarrhea associated with bacterial infections can reduce the duration and severity of illness and prevent complications. The availability of a predictive index before identification of causative bacteria would aid in the choice of a therapeutic agent.

Methods: The study included patients admitted to the pediatrics unit at Konyang University Hospital for acute inflammatory diarrhea from August 1, 2015 to July 31, 2016 who underwent multiplex polymerase chain reaction testing. Of 248 patients, 83 had positive results. The clinical symptoms and blood test results were examined in 61 patients with spp. (25 patients), spp. (18 patients), and (18 patients) infections. The mean age of the 61 patients (male:femal=31:30) was 84.0±54.8 months, and the mean hospital stay was 4.6±1.7 days.

Results: There were no statistical differences in sex, age, clinical symptoms, or signs. Patients with infection were significantly older (=0.00). C-reactive protein (CRP) levels in patients with infection were higher than those in the other 2 groups, at 9.6±6.1 mg/dL. The results of receiver-operating characteristic curve analysis showed that the cutoff age was ≥103.5 months (sensitivity, 72%; specificity, 86%) and the CRP cutoff level was ≥4.55 mg/dL (sensitivity, 80%; specificity, 69%).

Conclusion: Age (≥103.5 months) and higher CRP level (≥4.55 mg/dL) were good predictors of enterocolitis. If neither criterion was met, enterocolitis was unlikely (negative predictive value 97.2%). When both criteria were met, enterocolitis was highly likely.