La patogénesis de las enfermedades diarreicas agudas en los primeros años de vida

Abstract

In the City of Guatemala, diarrheal diseases are the principal cause of infant mortality. In order to clarify the pathogenesis of this type of malady, clinical and bacteriological investigations as well as autopsies were made on 63 consecutive deaths among hospitalized children. Fifty children had diarrheal disease and 35 of these showed advanced malnutrition. There was no evidence that the disease was attributable to a specific infectious agent, and only in 23 cases were bacterial pathogens present. In children who suffered at the same time from diarrheal disease and malnutrition, a non-ulcerous inflammatory response was noted in the jejunal mucosa, accompanied by a sharp local increase in the bacterial population. The author suggests that malnutrition in children may favor high bacterial populations in the jejunum and that their presence may be the cause of the non-ulcerative inflammatory reaction and the appearance of the symptoms of diarrheal disease. As therapeutic measures the use of antibiotics and rehydration to compensate for loss of liquids are recommended in the short run, and improvement of the nutritional state of patients in the long run