This page has moved. Click here to view.

Gastroenteritis

Acute gastroenteritis is defined as diarrheal disease of rapid onset, often with nausea, vomiting, fever, or abdominal pain. It occurs an average of 1.3-2.3 times per year between the ages of 0 and 5 years diarrhea, salmonella, rotavirus, shigella, gastroenteritis, ecoli, e coli. Rates among children in child care centers are

Viral Gastroenteritis

All of the viruses produce watery diarrhea often accompanied by vomiting and fever, usually not associated with blood or leukocytes in the stool or with

Rotavirus is the predominant viral cause of dehydrating diarrhea. Rotaviral infections tend to produce severe diarrhea, causing up to 70% of episodes in children under 2 years of age who require hospitalization. Rotavirus infection tends to occur in the fall in the southwest of the US, then sweeping progressively

Norwalk viruses are the major cause of large epidemics of acute nonbacterial gastroenteritis. In schools, camps, nursing homes, cruise ships, and restaurants.

Enteric adenovirus is the third most common organism isolated in infantile diarrhea.

Bacterial Gastroenteritis

The bacterial diarrheas work through the elaboration of toxin (enterotoxigenic pathogens) or through invasion and inflammation of the

Secretory diarrheas are modulated through an enterotoxin, and the patient does not have systemic symptoms (fever, myalgias) or signs of local irritation of the bowel (tenesmus), or evidence of gut inflammation in the stool (white or red blood cells). The diarrhea is watery, often is large in volume, and often associated with nausea and

Invasive diarrhea is caused by bacterial enteropathogens, and is accompanied by systemic signs, such as fever, myalgias, arthralgias, irritability, and loss of appetite. Cramps and abdominal pain are prominent. The diarrhea consists of the frequent passing of small amounts of "mucousy" stool. Stool examination reveals leukocytes, red blood cells, and often

The same organisms that typically cause an invasive or inflammatory pattern of illness also may cause a secretory or 

Clinical Evaluation and Treatment of Acute Diarrhea

Step One--Assess child for degree of dehydration

Step Two--Assess Clinical History for Etiologic Clues

Step Three--Examine Stool:

Fluid Therapy

Mild-to-moderate dehydration

Oral rehydration therapy (ORT) is the preferred method. ORT is a glucose-electrolyte solution.

Mildly or moderately dehydrated children should receive ORT at 50 mL/kg (mild dehydration) or 100 mL/kg (moderate dehydration) over a 4-hour period. Replacement of stool losses (at 10 mL/kg for each stool) and of emesis (estimated volume) will require adding appropriate amounts of solution to the total.

If all but sips of fluid are vomited, oral hydration can be achieved by administering a

 

Clinical Evaluation and Treatment of Persistent Diarrhea-lasting longer than 14 Days

Step--One

Assess child for degree of dehydration ------------> Appropriate rehydration

Step–Two. Assess Etiologic Clues

Step–Three. Stool Examination