小结
定义
Viral gastroenteritis is an infection of the gastrointestinal tract by a virus, usually rotavirus. It is usually self-limiting, but if untreated may result in morbidity and mortality secondary to dehydration, electrolyte imbalance, and metabolic acidosis.[Figure caption and citation for the preceding image starts]: Transmission electron micrograph of intact rotavirus particles, double-shelled. Distinctive rim of radiating capsomeresCDC/Dr Erskine Palmer; used with permission [Citation ends].
病史和体格检查
关键诊断因素
- age <5 years
- exposure to people with gastroenteritis
- lack of immunization against rotavirus
- vomiting
- nonbloody diarrhea
- hyperactive bowel sounds
其他诊断因素
- abdominal pain
- low-grade fever
- evidence of dehydration
- decreased body weight
- nondistended abdomen
- abdominal tenderness
- mucus in stool
危险因素
- age <5 years
- poor personal hygiene
- exposure to people with gastroenteritis
- daycare attendance
- winter months
- poverty
- lack of immunization against rotavirus
- lack of breast-feeding
- immunodeficiency
诊断性检查
首要检查
- clinical exam
需考虑的检查
- serum electrolytes, BUN, creatinine
- CBC
- blood cultures
- stool microscopy
- stool culture
- enzyme immunoassay (EIA) for detection of viral antigen
- stool electron microscopy
治疗流程
no dehydration
mild dehydration (<5%)
moderate dehydration (5% to 10%)
severe dehydration (>10%)
撰稿人
作者
Alexander K.C. Leung, MB BS, FRCPC, FRCP, FRCPCH, FAAP
Clinical Professor of Pediatrics
The University of Calgary
Calgary
Alberta
Canada
利益声明
AKCL is an author of a guideline and a number of references cited in this topic.
同行评议者
Saul Greenberg, MD
Associate Professor
Department of Paediatrics
University of Toronto
Ontario
Canada
利益声明
SG declares that he has no competing interests.
Y.L. Lau, MBCBhB, MD, FRCP, FRCPCH, FRCPS, FHKAM, FHKCPaed
Professor
Faculty of Medicine
University of Hong Kong
Hong Kong
利益声明
YLL declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Leung AK, Kellner JD, Davies HD. Rotavirus gastroenteritis. Adv Ther. 2005 Sep-Oct;22(5):476-87. 摘要
Cortese MM, Parashar UD; Centers for Disease Control and Prevention. Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2009 Feb 6;58(RR-2):1-25.全文 摘要
Le Saux N; Canadian Pediatric Society. Position statement: recommendations for the use of rotavirus vaccines in infants. Oct 2018 [internet publication].全文
Leung A, Prince T; Canadian Paediatric Society. Oral rehydration therapy and early refeeding in the management of childhood gastroenteritis. Paediatr Child Health. 2006 Nov;11(8):527-31.全文
Carter B, Fedorowicz Z. Antiemetic treatment for acute gastroenteritis in children: an updated Cochrane systematic review with meta-analysis and mixed treatment comparison in a Bayesian framework. BMJ Open. 2012 Jul 19;2(4):e000622.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Bacterial gastroenteritis
- Protozoal gastroenteritis
- Food poisoning
更多 鉴别诊断指南
- Child and adolescent immunization schedule by age: recommendations for ages 18 years or younger, United States, 2025
- Recommendations for the use of rotavirus vaccines in infants
更多 指南患者教育信息
Diarrhea in children
Rotavirus vaccine
更多 患者教育信息
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