Gastroenteritis (Infectious Diarrhoea)

» Paediatrics

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

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.

Watch Video Gastroenteritis (Paediatric) - Overview

Signs and Symptoms

Clinical Triad of Gastroenteritis: fever, vomiting, diarrhoea

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

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

Complications

Dehydration
Electrolyte imbalance
Acidosis
Septicaemia
Meningitis

References

Royal Children Hospital Melbourne

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Field of Study

Post Type

Gastroenteritis (Infectious Diarrhoea)

Overview

Signs and Symptoms