Gastroenteritis Flashcards
List the common causes of gastroenteritis?
Rotavirus (most common) Norovirus, adenovirus, coronavirus Campylobacter Shigella Salmonella E. coli
What are the symptoms of gastroenteritis?
Diarrhoea Vomiting Fever Abdo pain Malaise Not eating and drinking Dehydration or even shock
If there’s blood and mucus in the diarrhoea what bug would you predict is the cause?
Shigella
Salmonella
If there’s severe abdominal pain, what bug would you predict is the cause?
Campylobacter
What are the symptoms of dehydration?
Altered responsiveness Dry mucous membranes Decreased urine output Sunken eyes Sunk fontanelle Tachycardia and Tachypnoea Reduced skin turgor
What are the symptoms of shock that aren’t present with dehydration?
Decreased consciousness Pale, mottled skin Cold extremities Grossly sunken eyes Weak pulses Prolonged cap refill time Hypotension
If you see a child with hypotension, should you be worried?
Yes, its a late sign and means they’re very ill
Normally would you investigate gastroenteritis?
In what situations would you investigate and what would you do?
No not usually
If there is dehydration do bloods: U+E, glucose, creatinine
Do a stool sample if blood and mucus in diarrhoea, if they’re septic, if they are immunocompromised
If you’re starting antibiotics, then take blood cultures
In a case of a child with rotavirus gastroenteritis with no dehydration and no underlying medical problems, what would your management plan be?
No management
Advise to keep hydrated with breast milk, water
Advise to be alert for signs of dehydration
In children with bacterial gastroenteritis when would you prescribe antibiotics?
If there’s suspected sepsis
If they’ve got salmonella and are under 6 months
If they’re immunocompromised
Some bacteria will need antibiotic therapy: C diff, cholera, shigellosis, giardiasis
In a case of a child with rotavirus gastroenteritis where there is dehydration, what would your management plan be?
Oral rehydration solution
Plus normal fluids
If not effective then IV rehydration
What’s the dose of oral rehydration solution in children?
50ml/kg
In a case of a child who is in shock during rotavirus gastroenteritis, what would your management plan be?
ABCDE
IV fluid bolus
Then IV rehydration
If no improvement consider PICU
Which antibiotic would you prescribe for campylobacter?
Azithromycin
