Paediatrics - Queensland Health - Queensland Government
Paediatrics - Queensland Health - Queensland Government
Paediatrics - Queensland Health - Queensland Government
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5. Follow up<br />
Review 1 - 2 days after starting on low lactose formula<br />
Consult MO if diarrhoea persists<br />
See next Child <strong>Health</strong> Nurse or MO clinic<br />
6. Referral / consultation<br />
Consult MO on all occasions lactose intolerance suspected<br />
Dietitian if available<br />
Gastrointestinal problems<br />
Giardiasis<br />
Recommend<br />
If treatment with tinidazole or metronidazole fails a longer course may be required or<br />
reconsider the diagnosis<br />
Related topics<br />
Anaemia - child Acute gastroenteritis and dehydration<br />
Failure to thrive<br />
1. May present with<br />
• Foul smelling watery diarrhoea<br />
• Chronic diarrhoea, frequent loose and pale greasy stool<br />
• Abdominal cramps<br />
• Abdominal distension, flatulence<br />
• Nausea, poor appetite<br />
• Anaemia<br />
• Weight loss / failure to thrive<br />
• May be asymptomatic<br />
2. Immediate management Not applicable<br />
3. Clinical assessment<br />
• Perform standard clinical observations +<br />
-- weigh - use naked weight in young children and record against most recent<br />
weight<br />
• Collect a faeces specimen for MC/S and OCP (ova, cysts and parasites) x 2<br />
• Perform physical examination:<br />
- - assess for dehydration. See Clinical assessment of hydration in children<br />
-- palpate the abdomen for tenderness or guarding<br />
-- inspect the perianal area for signs of irritation<br />
4. Management<br />
• Encourage oral fluids<br />
• Treatment of people with asymptomatic passage of cysts is unwarranted unless<br />
they are a contact of pregnant women or immunocompromised patient<br />
• Treat with tinidazole or metronidazole if symptomatic, or failure to thrive (it is not<br />
necessary to wait for laboratory confirmation). If thriving and not unwell treat after<br />
laboratory confirmation<br />
Primary Clinical Care Manual 2011 Controlled copy V 1.0 611
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