Gastroenteritis (Infectious Diarrhoea)
Overview
Gastroenteritis continues to cause significant morbidity in developed and developing countries. The most common cause are viral and bacterial including:
- Norovirus
- Enteric adenoviruses
- E-coli
- Salmonella spp. and Shigella spp.
- Campylobater jejuni
Definition
Diarrhoea: Loose, water like stools that occur with increased frequency and an increased volume of >200g per day
Gastroenteritis: >3 or more loose stools per day for <14 days
Chronic Diarrhoea: Diarrhoea that continue for more than 2 weeks
Malabsorption: Defined as the failure to absorb nutrients
Toddlers Diarrhoea: Clinical syndrome characterised by chronic diarrhoea often with undigested food in the stools of a child who is otherwise well, gaining weight and growing satisfactorily.
Gastroenteritis is usually self-resolving. Parasitic infection are uncommon but can be dangerous.
Clinical Manifestation
It is important to assess state of dehydration because this will tailor treatment. Dehydration can be either mild, moderate or severe.
Diagnosis
Viral Gastroenteritis
- Rotavirus (most common)
- Noravirus
- Adenovirus
- Hepatitis A, B, C, E
Bacterial Gastroenteritis
- E-coli
- Clostridium difficile
- Salmonella
- Shigella
- Campylobacter jejuni
Most bacterial causes of diarrhoea are self-limiting and do not usually require antibiotic therapy.
Parasitic Gastroenteritis
- Giardia Lamblia
- E. vermicularis
Investigations
- Full Blood Count
- EUC
- LFT
- CRP
- Enzyme immunoassay
- PCR
- Stool culture
- Blood culture
- Viral causes – Enzyme immunoassay and latex agglutination
- Bacterial causes – Stool and Blood culture +/- polymerase chain reaction (PCR)
- Parasitic causes – Microscopy of stool +/- PCR
Complications and Prognosis
- Dehydration
- Electrolyte imbalance
- Acidosis
- Septicaemia
- Meningitis
References
Royal Children Hospital Melbourne
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