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Viral gastroenteritis in children

Last reviewed: 6 Apr 2025
Last updated: 22 Feb 2024

Summary

Definition

History and exam

Key diagnostic factors

  • age <5 years
  • exposure to people with gastroenteritis
  • lack of immunization against rotavirus
  • vomiting
  • nonbloody diarrhea
  • hyperactive bowel sounds
Full details

Other diagnostic factors

  • abdominal pain
  • low-grade fever
  • evidence of dehydration
  • decreased body weight
  • nondistended abdomen
  • abdominal tenderness
  • mucus in stool
Full details

Risk factors

  • 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
Full details

Diagnostic tests

1st tests to order

  • clinical exam
Full details

Tests to consider

  • serum electrolytes, BUN, creatinine
  • CBC
  • blood cultures
  • stool microscopy
  • stool culture
  • enzyme immunoassay (EIA) for detection of viral antigen
  • stool electron microscopy
Full details

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Leung AK, Kellner JD, Davies HD. Rotavirus gastroenteritis. Adv Ther. 2005 Sep-Oct;22(5):476-87. Abstract

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.Full text  Abstract

Le Saux N; Canadian Pediatric Society. Position statement: recommendations for the use of rotavirus vaccines in infants. Oct 2018 [internet publication].Full text

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.Full text

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.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • 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, 2024
    • Recommendations for the use of rotavirus vaccines in infants
    More Guidelines
  • Patient information

    Diarrhea in children

    Rotavirus vaccine

    More Patient information
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