Simon Rabinowitz Ph.D MD Pediatric GI, Chairman Department of Pediatric Richmond University Medical Center, discusses Travelers Diarrhea.
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Interviewer: They recently took a trip to Mexico and the will eating a lot of food and they were in cattle. Could it be in something in that history that involves you a little bit? Interviewee: Well that type of a history is suggested that the child might to pick up some of sort of an infection when the child was in a different environment. The most common infection that one would get in Mexican trouble as well as most of the Caribbean and part of Latin America is referred to us Traveler Diarrhea. And there is not necessarily as the specific bacteria that necessary to eradicate however the introduction of certain foods especially water that’s not been purified can cause a change in the normal bacteria that leave in the colon and it’s the consequence there can be abdominal pain and usually are almost always associated with diarrhea. However if the pain is specially localize to the right side of the upper abdomen then one has to think about that possibility of not only a parasite but the parasite is also affecting the liver. Interviewer: What is the most common parasite you would be thinking about/ Interviewee: In this particular setting the most common parasite would be amoeba and that we know is the oral point of children and adult in the New York but most probably are getting from the worker or a food preparer who has not use the perfect technique but it certainly very widespread. In fact a lot of these parasites are so common those in large, large regions of the world there is more people admit and donor. Interviewer: How do you make a diagnosis if you have the kid that can’t’ here? Interviewee: The first step in trying to make that diagnosis would be to look in the stool to see if there the actual parasite itself or the egg or the ovum of the parasite. Interviewer: If one stool evaluation enough? Interviewee: Usually if sometimes if you are lucky and more than half of time that will be but usually what we recommend is that the child have that least three specimen submitted and a very important part of the process of getting the most information as possible with at least the work for the parent is to stays the specimen apart within 48 hours because there are some types of bug which has the cycle it shading and so if you get three specimen to all from diarrhea on Monday it’s not nearly as valuable as going Monday, Wednesday and Friday. Interviewer: All labs are capable during this test accurately or some labs better than another? Interviewee: Certainly some laboratories are better than others but for the mass majority if you go to a skin and laboratory of they don’t have the ability to do it in house for instance let say with the a class on toxin of bacterial infection that toxin mediated that’s closing more and more serious problems in older people and I believe also which seen in more in kids is sanded out. So any reliable laboratory should be able to do this. Interviewer: If a friend dissolve like in Mexico over Caribbean came to New York City they were about to reverse of travelers diarrhea? Could they this from us? Interviewee: Not normally because they’ve been expose to such a large variety of microorganism in there environment that the one is that people are not encounter here it probably seen in it and that going to be bother at might much vitamin. Interviewer: If you happen to be Mexico and you are getting a lot of law schools what would be the best in voice you give for them so they can probably manage there trip. Interviewee: Well the best idea will be to try kill some of those bacteria that they probably become expose too, and medication as such as bactrim as long as they are not in type result to allergy or Septra would be perfectly adequate to give and in young kids who are at risk for having more severe consequences who are going to this areas are often advice that they take some with them. Another med that can be use which is not full growth but can provide a little bit of the protection is the ingestion of p