Viral gastroenteritis is typically a self-limited condition lasting <14 days. Frequent symptoms are nausea, vomiting, and diarrhea, which may be accompanied by fever, abdominal pain, and anorexia.
Viral gastroenteritis is the most common cause of acute gastroenteritis in the US and worldwide.
Person-to-person transmission is responsible for infection in most sporadic cases. Foodborne and waterborne epidemic outbreaks have the potential to involve large numbers of people.
Mostly caused by norovirus.
Rotavirus is the most common cause of severe diarrhea in young children. It also causes symptomatic infection in older people and in immunocompromised adults.
Diagnosis is usually made clinically. Although not routinely necessary, confirmation is by polymerase chain reaction, antigen-detecting enzyme immunoassays, immunofluorescence assays, microscopy, serology, and viral culture.
Optimal management is with oral rehydration therapy for mild and moderate cases and intravenous fluids for severe cases, plus adequate nutrition. Routine use of antibiotics is not recommended and may cause harm. Antiemetics are recommended only for patients with intractable vomiting. Antidiarrheal agents are usually not required but may be used for symptomatic relief of watery diarrhea.
Prevention through good hygiene is the key to controlling viral gastroenteritis. In addition, rotavirus vaccines have been approved for infants.
Viral gastroenteritis is the acute inflammation of the lining of the stomach and intestines caused by enteropathogenic viruses. The typical presentation is an increased frequency of defecation lasting less than 14 days, which may be accompanied by nausea, vomiting, anorexia, abdominal cramps, and fever. Rarely, the volume depletion is significant enough to cause hospitalization or even death.
History and exam
Key diagnostic factors
- abdominal pain
Other diagnostic factors
- volume depletion
- exposure to contaminated food or water sources
- close contact with infected people
- poor hygiene
- extreme ages
- HIV infection
- organ transplantation
- chronic illness
1st investigations to order
- clinical diagnosis
Investigations to consider
- basic metabolic profile
- renal function
- stool rapid antigen testing
- stool reverse transcriptase polymerase chain reaction (RT-PCR) or multiplex PCR
- stool viral culture
- stool electron microscopy
- stool for culture, ova, and parasites
mild to moderate volume depletion
severe volume depletion
- Bacterial gastroenteritis
- Protozoal infections
- Helminthic infections
- ACR appropriateness criteria: right upper quadrant pain
Diarrhea in adults
Diarrhea in childrenMore Patient leaflets
- Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer