Associated with substantial morbidity in developed countries. Continues to be a cause of significant mortality in developing countries.
Presents with vomiting and diarrhoea (with or without fever, nausea, or abdominal pain).
Dehydration, which may be associated with electrolyte imbalance and metabolic acidosis, is the most frequent and dangerous complication.
Oral rehydration therapy is the mainstay of treatment.
Self-limiting disease with excellent prognosis if correctly treated.
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.
History and exam
Key diagnostic factors
- presence of risk factors
- non-bloody diarrhoea
- hyperactive bowel sounds
Other diagnostic factors
- abdominal pain
- low-grade fever
- evidence of dehydration
- decreased body weight
- non-distended abdomen
- abdominal tenderness
- mucus in stool
- age <5 years
- poor personal hygiene
- exposure to people with gastroenteritis
- day-care attendance
- winter months
- lack of immunisation against rotavirus
- lack of breastfeeding
1st investigations to order
- clinical examination
Investigations to consider
- serum electrolytes, urea, creatinine
- stool microscopy
- stool culture
- enzyme immunoassay (EIA) for detection of viral antigen
- stool electron microscopy
mild dehydration (<5%)
moderate dehydration (5% to 10%)
severe dehydration (>10%)
Alexander K.C. Leung, MB BS, FRCPC, FRCP, FRCPCH, FAAP
Clinical Professor of Pediatrics
The University of Calgary
AKCL is an author of a guideline and a number of references cited in this topic.
Saul Greenberg, MD
Department of Paediatrics
University of Toronto
SG declares that he has no competing interests.
Y.L. Lau, MBCBhB, MD, FRCP, FRCPCH, FRCPS, FHKAM, FHKCPaed
Faculty of Medicine
University of Hong Kong
YLL declares that he has no competing interests.
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