Viral gastroenteritis in children

Last reviewed: 6 Sep 2022
Last updated: 04 Aug 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • age <5 years
  • exposure to people with gastroenteritis
  • lack of immunisation against rotavirus
  • vomiting
  • non-bloody diarrhoea
  • hyperactive bowel sounds
More key diagnostic factors

Other diagnostic factors

  • abdominal pain
  • low-grade fever
  • evidence of dehydration
  • decreased body weight
  • non-distended abdomen
  • abdominal tenderness
  • mucus in stool
Other diagnostic factors

Risk factors

  • age <5 years
  • poor personal hygiene
  • exposure to people with gastroenteritis
  • daycare attendance
  • winter months
  • poverty
  • lack of immunisation against rotavirus
  • lack of breastfeeding
  • immunodeficiency
More risk factors

Diagnostic investigations

1st investigations to order

  • clinical examination
More 1st investigations to order

Investigations to consider

  • serum electrolytes, urea, creatinine
  • FBC
  • blood cultures
  • stool microscopy
  • stool culture
  • enzyme immunoassay (EIA) for detection of viral antigen
  • stool electron microscopy
More investigations to consider

Treatment algorithm

ACUTE

no dehydration

mild dehydration (<5%)

moderate dehydration (5% to 10%)

severe dehydration (>10%)

Contributors

Authors

Alexander K.C. Leung, MB BS, FRCPC, FRCP, FRCPCH, FAAP
Alexander K.C. Leung

Clinical Professor of Pediatrics

The University of Calgary

Calgary

Alberta

Canada

Disclosures

AKCL is an author of a guideline and a number of references cited in this topic.

Peer reviewers

Saul Greenberg, MD

Associate Professor

Department of Paediatrics

University of Toronto

Ontario

Canada

Disclosures

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

Disclosures

YLL declares that he has no competing interests.

  • Viral gastroenteritis in children images
  • Differentials

    • Bacterial gastroenteritis
    • Protozoal gastroenteritis
    • Food poisoning
    More Differentials
  • Guidelines

    • Recommended child and adolescent immunization schedule for ages 18 years or younger, United States, 2022
    • Fever in under 5s: assessment and initial management
    More Guidelines
  • Patient leaflets

    Diarrhoea in children

    Rotavirus vaccine

    More Patient leaflets
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