Viral gastroenteritis in children
Resumo
Definição
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].
História e exame físico
Principais fatores diagnósticos
- age <5 years
- exposure to people with gastroenteritis
- lack of immunization against rotavirus
- vomiting
- nonbloody diarrhea
- hyperactive bowel sounds
Outros fatores diagnósticos
- abdominal pain
- low-grade fever
- evidence of dehydration
- decreased body weight
- nondistended abdomen
- abdominal tenderness
- mucus in stool
Fatores de risco
- 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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- clinical exam
Investigações a serem consideradas
- serum electrolytes, BUN, creatinine
- CBC
- blood cultures
- stool microscopy
- stool culture
- enzyme immunoassay (EIA) for detection of viral antigen
- stool electron microscopy
Algoritmo de tratamento
no dehydration
mild dehydration (<5%)
moderate dehydration (5% to 10%)
severe dehydration (>10%)
Colaboradores
Autores
Alexander K.C. Leung, MB BS, FRCPC, FRCP, FRCPCH, FAAP
Clinical Professor of Pediatrics
The University of Calgary
Calgary
Alberta
Canada
Declarações
AKCL is an author of a guideline and a number of references cited in this topic.
Revisores
Saul Greenberg, MD
Associate Professor
Department of Paediatrics
University of Toronto
Ontario
Canada
Declarações
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
Declarações
YLL declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Leung AK, Kellner JD, Davies HD. Rotavirus gastroenteritis. Adv Ther. 2005 Sep-Oct;22(5):476-87. Resumo
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.Texto completo Resumo
Le Saux N; Canadian Pediatric Society. Position statement: recommendations for the use of rotavirus vaccines in infants. Oct 2018 [internet publication].Texto completo
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.Texto completo
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.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Bacterial gastroenteritis
- Protozoal gastroenteritis
- Food poisoning
Mais Diagnósticos diferenciaisDiretrizes
- 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
Mais DiretrizesFolhetos informativos para os pacientes
Diarrhea in children
Rotavirus vaccine
Mais Folhetos informativos para os pacientes
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal