Summary
Definition
A gastroenterite viral é uma infecção do trato gastrointestinal por um vírus, geralmente o rotavírus. Em geral, ela é autolimitada, mas se não tratada pode resultar em morbidade e mortalidade secundárias à desidratação, desequilíbrio eletrolítico e acidose metabólica.[Figure caption and citation for the preceding image starts]: Eletromicrografia de transmissão mostrando partículas do rotavírus intacto, de dupla camada. Borda nítida dos capsômeros que se irradiamCentros de Controle e Prevenção de Doenças (CDC)/Dr. Erskine Palmer; usado com permissão [Citation ends].
History and exam
Key diagnostic factors
- presença de fatores de risco
- idade <5 anos
- exposição a pessoas com gastroenterite
- ausência de imunização contra rotavírus
- vômitos
- diarreia não hemorrágica
- ruídos hidroaéreos hiperativos
Other diagnostic factors
- dor abdominal
- febre baixa
- evidências de desidratação
- redução no peso corporal
- abdome não distendido
- desconforto abdominal
- muco nas fezes
Risk factors
- idade <5 anos
- falta de higiene pessoal
- exposição a pessoas com gastroenterite
- frequentar creches
- meses do inverno
- pobreza
- ausência de imunização contra rotavírus
- ausência de amamentação
- imunodeficiência
Diagnostic investigations
1st investigations to order
- exame clínico
Investigations to consider
- eletrólitos séricos, ureia e creatinina
- Hemograma completo
- hemoculturas
- microscopia das fezes
- coprocultura
- ensaio imunoenzimático (EIE) para detecção do antígeno viral
- microscopia eletrônica de fezes
Treatment algorithm
sem desidratação
desidratação leve (<5%)
desidratação moderada (5% a 10%)
desidratação grave (>10%)
Contributors
Authors
Alexander K.C. Leung, MB BS, FRCPC, FRCP, FRCPCH, FAAP
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
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.
Differentials
- Gastroenterite bacteriana
- Gastroenterite protozoária
- Intoxicação alimentar
More DifferentialsGuidelines
- Child and adolescent immunization schedule by age: recommendations for ages 18 years or younger, United States, 2025
- Fever in under 5s: assessment and initial management
More GuidelinesPatient information
Vacina contra o rotavírus
Diarreia em crianças
More Patient information
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