Amoeba

[Mike45]

My 13 month daughter has an amoeba verified by stool sample taken last Monday/Tuesday.

She has had Diarear for 8 days and drinking babylyte. He says she is not dehydrated she appears well and happy.

Last Wednesday she had low fever but its gone. Doctor put her on Flagyl (metronidazole) last Tuesday. Today the doctor added Suprax 100 ( Cefixime) and a Kaopectate type product.

I'm concerned that the Flagyl hasn't cleared this up yet. I'm thinking of going out and buying a different manufacturers bottle of the same drug maybe the one we have, made in Saudi, is weak.

Is this typical?

[lemonjelly]

Flagyl is an antibiotic for treatment of anaerobic bacteria (if my memory serves me correctly), she needs anti amoeba medication.

[Mike45]

It's metronidazole benzoate Flazol

[AyG]

Flagyl is an antibiotic for treatment of anaerobic bacteria (if my memory serves me correctly), she needs anti amoeba medication.

It's both antibiotic and antiprotozoal, so should probably deal with the amœba.

[AyG]

The fact that the doctor added Cefixime would suggest that he/she now thinks the diarrhea may be bacterial, rather than amœbic. (The amœbae in the stool may simply have been a coincidence.) It would, however, be informative to do a repeat stool sample test to see if the amœbae have gone.

Edited October 6, 2015 by AyG

[oncearugge]

You should not even consider self medicating a child so young.

Follow the Doctor's advice or obtain a second Medical opinion.

Despite what some other posters have said metronidazole (Flagyl) is used, legitimately, for the treatment of amebic dysentery.

[Mike45]

You should not even consider self medicating a child so young.

Follow the Doctor's advice or obtain a second Medical opinion.

Despite what some other posters have said metronidazole (Flagyl) is used, legitimately, for the treatment of amebic dysentery.

I agree. We are following doctors advice.

[Sheryl]

As AyG said, the addition of the second drug suggests that the doctor thinks the diarrhea may not be due to the amoeba.

Best advice I can give is to get a second opinion if the diarrhea persists. where do you live ?

[Halsted6]

Metronidazole is the standard initial treatment for amoebiasis and then cefixime is added when the amoebiasis is severe and the metronidazole alone won't cut it.

[Mike45]

As AyG said, the addition of the second drug suggests that the doctor thinks the diarrhea may not be due to the amoeba.

Best advice I can give is to get a second opinion if the diarrhea persists. where do you live ?

We're thinking the same thing but wanted to see if the addition of the Suprax 100 helped her. She gets 5 ml every 24 hours. Tonight she had her second dose.

She doesn't appear dehydrated and she is drinking babylyte as well as being breast feed and eating most everything we eat. She is happy and energetic.

We are thinking that if tomorrow she still has diarear we will bring her to the pediatric emergency room at the International Medical Center in Jeddah.

[oncearugge]

As AyG said, the addition of the second drug suggests that the doctor thinks the diarrhea may not be due to the amoeba.

Best advice I can give is to get a second opinion if the diarrhea persists. where do you live ?

We're thinking the same thing but wanted to see if the addition of the Suprax 100 helped her. She gets 5 ml every 24 hours. Tonight she had her second dose.

She doesn't appear dehydrated and she is drinking babylyte as well as being breast feed and eating most everything we eat. She is happy and energetic.

We are thinking that if tomorrow she still has diarear we will bring her to the pediatric emergency room at the International Medical Center in Jeddah.

You can look up and make an appointment with one of the IMC doctors here.

http://beta.imc.med.sa/imc/en/doctors-search?combine=&tid=26&field_doctor_s_location_tid=All

Search under "location" for Consultants associated with the Children's Health Centre

[Sheryl]

From what you describe there is no need for an ER visit, but a consultation with a carefully selected pediatrician would be in order. Making sure it includes a repeat stool test.

An otherwise healthy looking child with chronic diarrhea is often a case of giardia. Are you sure the original test showed amoeba and not protozoa (which is what giardia is - and also treated with flagyl).? If so, giardia is sometimes resistant to flagyl.

[Mike45]

From what you describe there is no need for an ER visit, but a consultation with a carefully selected pediatrician would be in order. Making sure it includes a repeat stool test.

An otherwise healthy looking child with chronic diarrhea is often a case of giardia. Are you sure the original test showed amoeba and not protozoa (which is what giardia is - and also treated with flagyl).? If so, giardia is sometimes resistant to flagyl.

Her pediatrician is at this hospital but require a month to get appointment. No one at this hospital has seen her for this condition. It was a local doctor and hospital that ran the test. I can only go by what they told me and they said amoeba. They also tested the whole family and all came out negative.

I realize it's not an emergency but it will be the easiest and fastest way to see a doctor.

[Mike45]

From what you describe there is no need for an ER visit, but a consultation with a carefully selected pediatrician would be in order. Making sure it includes a repeat stool test.

An otherwise healthy looking child with chronic diarrhea is often a case of giardia. Are you sure the original test showed amoeba and not protozoa (which is what giardia is - and also treated with flagyl).? If so, giardia is sometimes resistant to flagyl.

Spoke to the local doctor today he said that the test results were negative for rotavirus and positive for ameaba. He agrees she needs another test and He gave me a sample cup to fill and bring with me to the IMC.

[Mike45]

Pediatrician ran the sample and told me no sign of ameaba. Told is to stop the Flazol but continue the Suprax until I get to the seventh day of use. He prescribed pediasure and probiotic sachets which I couldn't find at the pharmacy

[Mike45]

Pediatrician ran the sample and told me no sign of ameaba. Told is to stop the Flazol but continue the Suprax until I get to the seventh day of use. He prescribed pediasure and probiotic sachets which I couldn't find at the pharmacy

I found the probiotic and I'm hopeful they will help.

Also I forgot to mention they were culturing the sample.

[Sheryl]

The pediatrician's advice sounds reasonable.

If after complete course of the Suprax and addition of probiotics there is still no improvement, and if the culture shows nothing, may have to consider other non-infective causes such as food allergy or intolerance. The fact that there was amoeba on the initial stool test does not necessarily mean the amoeba was the cause of the diarrhea, could have been an incidental finding as it does not always cause symptoms.

[Mike45]

Pediatrician ran the sample and told me no sign of ameaba. Told is to stop the Flazol but continue the Suprax until I get to the seventh day of use. He prescribed pediasure and probiotic sachets which I couldn't find at the pharmacy

I found the probiotic and I'm hopeful they will help.

Also I forgot to mention they were culturing the sample.

The culture came back negative for everything.

The diarear persists. She has now the additional symptoms of a cold, mucus and fever. Last night the fever went to 101 F and we gave her a paracetamol suppository and her fever went down.

[Sheryl]

Since the cold just started presumably not connected (though babies/small children often will get diarrhea any time they are sick with something else).

Think back to when the diarrhea first started. In te weeks/month prior, any new foods introduced or other changes in eating habits?

[Mike45]

Since the cold just started presumably not connected (though babies/small children often will get diarrhea any time they are sick with something else).

Think back to when the diarrhea first started. In te weeks/month prior, any new foods introduced or other changes in eating habits?

It's worrying me that as soon as she was off the Suprax she got a fever and cold symptoms.

She is still being breast feed. There have been no new foods introduced or changes in eating habits.

The month prior we traveled a lot..USA, Thailand, so if it had happened then I would accept it was because of different food or water. This situation didn't begin until we were back in Saudi for a week.

Perhaps she has a bacterial infection in her intestinal tract that couldn't be killed by the Suprax. Maybe it's not a wide band antibiotic.

I'm going to take her back to the pediatric emergency room today with another stool sample. Tried to setup an appointment with her pediatrician there but was told October 22.

[Sheryl]

Colds are viral in nature and taking or not taking antibiotics has no effect. Be forewarned your child is entering the ages where frequent respiratory infections are to be expected.

Suprax is a very broad spectrum cephalosporin and would be effective against most like bacterial causes of diarrhea. However, like most antibiotics it in itself can also cause diarrhea. This is a definite likelihood given the negative stool test.

If this is the culprit the diarrhea will gradually resolve after finishing the course of Suprax.

[oncearugge]

Colds are viral in nature and taking or not taking antibiotics has no effect. Be forewarned your child is entering the ages where frequent respiratory infections are to be expected.

Suprax is a very broad spectrum cephalosporin and would be effective against most like bacterial causes of diarrhea. However, like most antibiotics it in itself can also cause diarrhea. This is a definite likelihood given the negative stool test.

If this is the culprit the diarrhea will gradually resolve after finishing the course of Suprax.

Agreed.

However, if the diarrhea does not settle, then, in conjunction with a Pediatrician, changes to the baby's diet should be considered.