Armando Hasudungan

Biology and Medicine Tutorials

Gastroenteritis (Infectious Diarrhoea)

Overview

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

overview

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.

Signs and Symptoms

Clinical Triad of Gastroenteritis: fever, vomiting, diarrhoea

clinical presentation

It is important to assess state of dehydration because this will tailor treatment. Dehydration can be either mild, moderate or severe.

category

Differential Diagnosis

Viral Gastroenteritis

  • Rotavirus (most common)
  • Noravirus
  • Adenovirus
  • Hepatitis A, B, C, E

Bacterial Gastroenteritis

  • E-coli
  • Clostridium difficile
  • Salmonella
  • Shigella
  • Campylobacter jejuni
Side note Most bacterial causes of diarrhoea are self-limiting and do not usually require antibiotic therapy.

Parasitic Gastroenteritis

  • Giardia Lamblia
  • E. vermicularis
Watch Video Giardia Lamblia
Watch Video Pin Worms - Enterobius Vermicularis

Investigations

  • Full Blood Count
  • EUC
  • LFT
  • CRP
  • Enzyme immunoassay
  • PCR
  • Stool culture
  • Blood culture

Diagnosis

  • Viral causes - Enzyme immunoassay and latex agglutination
  • Bacterial causes - Stool and Blood culture +/- polymerase chain reaction (PCR)
  • Parasitic causes - Microscopy of stool +/- PCR

Management

algo

Complications

Complication

  • Dehydration
  • Electrolyte imbalance
  • Acidosis
  • Septicaemia
  • Meningitis

References

Royal Children Hospital Melbourne
Contents
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