GASTROENTERITIS Dr tariq al thobiti

Diarrheal diseases are the second leading cause of death worldwide in children. Rotavirus is the most common pathogen in areas without a vaccination program. in areas with widespread rotavirus vaccination, norovirus is the most common pathogen.

CLINICAL FEATURES Diarrhea associated with acute viral gastroenteritis typically lasts <7 days and not longer than 14 days, and it may be accompanied by vomiting or fever. Isolated vomiting should not be diagnosed as acute gastroenteritis.

CLINICAL FEATURES Although appendicitis typically manifests with abdominal pain followed by vomiting associated with constipation, it may also cause diarrhea, particularly once the appendix has perforated. This is presumed to occur because the inflammation irritates the colon, resulting in diarrhea

LABORATORY TESTING Obtain a CBC only if the child is ill appearing or has bloody diarrhea. (mainly to identify bacterial enterocolitis or hemolytic- uremic syndrome). The WBC count and C-reactive protein are not reliable for distinguishing viral from bacterial gastroenteritis.

LABORATORY TESTING Given that the reported prevalence of hypoglycemia may be as high as 9% in pediatric gastroenteritis. measuring serum glucose in infants and young children is essential. Obtain serum electrolytes only in specific circumstances.

LABORATORY TESTING BUN is elevated in severe dehydration. it does not identify lesser degrees of dehydration very well. Serum bicarbonate>15 mEq/L makes dehydration unlikely.