14. Gastroenteritis Flashcards
List the aetiology of gastroenteritis
Rotavirus (most common infantile) - vaccine at 8 + 12w
Norovirus (most common viral)
Adenovirus - <2y
Campylobacter (most common bacterial)
VTEC E.coli
Describe the signs and symptoms of gastroenteritis
- Sudden onset of loose/watery stool with/out vomiting
- Abdo pain/cramps
- Mild fever
- Recent contact with someone with D/V
It is important to identify children at risk of what?
DEHYDRATION
Greatest risk =
- Young children (especially under 6months).
- Children passed >5 diarrhoeal stools in the last 24h
- Children vomited >2x in the last 24h
- Children stopped breast feeding during the illness
How should suspected gastroenteritis be Ix?
Stool sample for microbiology if:
- Septicaemia suspected
- blood/mucus in the stool
- immunocompromised
Measure Na+, K+, Cr, Ur and glucose if:
- IV fluids going to be used
- Sx/signs of hypernatraemia (jittery, increased muscle tone, hyperreflexia, convulsions, drowsiness, coma)
Acid-base status and [chloride] if shock suspected
How should gastroenteritis be Mx?
NOT DEHYDRATED =
- continue breast/formula feed
- oral fluids
- discourage fruit juices and carbonated drinks
- risk of dehydration = oral rehydration salt solution (ORS)
DEHYDRATED =
- IV therapy: shock, red flag Sx, persistent vomiting when ORS given
- Oral therapy: ORS 50ml/kg over 4h, if not tolerated NG tube
FOLLOWING REHYDRATION =
- full strength milk straight away
- slowly introduce solid food
- no school 48h
What are the possible complications of gastroenteritis?
Haemolytic uraemic syndrome
Reactive complications = arthritis, carditis, urticaria, erythema nodosum and conjunctivitis
Toxic megacolon
Acquired/secondary lactose intolerance
