Viral gastroenteritis (DNF)

Question 1

Define gastroenteritis

Answer 1

An enteric infection causing acute-onest diarrhoea, with or without associated symptoms

Question 2

What is the difference between acute, prolonged diarrhoea and dysentry?

Answer 2

Acute - 3+ episodes or liquid/semi-liquid stools in 24hrs, laess than 14 days
Prolonged - lasting over 14 days
Dysnetery - acute infections with blood mucus and often associated symptoms

Question 3

What are the common causes of viral gastroenteritis?

Answer 3

Rotavirus - children
Norovirus - general population, projectile vomiting and non-bloody diarrhoea
Adenovirus - RTI and GIT symptoms

Question 4

What are the common causes of bacterial gastroenteritis?

Answer 4

Campylobacter - contam food (BBQ), gram neg rods
E.coli - travelers, blood in diarrhoea, haemolytic uraemia syndrome
Salmonella - sepsis, endocarditis, mycotic aneurysm and osteomyelitis
Cholera
Shigella and Yersinia -> children

Question 5

What are the signs and symptoms of viral gastroenteritis?

Answer 5

Sudden-onset diarrhoea, with or without blood
Faecal urgency
Nausea and vomiting
Fever, malaise
Abdo pain
Associated symptoms specific to the cause

Question 6

What investigations may be done for gastroenteritis?

Answer 6

Hydration status
Stool culture
Secondary care - FBCs, U&Es, CRP, LFTs and TFT
Consider: VBG, blood cultures and urine output if they appear septic.

Question 7

What is teh typical treatment for gastroenteritis?

Answer 7

A-E approach and consider the sepsis six.
May need IV fluids, antiemetics or antibiotics.
Conservative - advise regular fluids, may need rehydrations salts and safety net for dehydration
Antidiarrhoeal drugs - not routine avoid if e.coli or dysentery

Question 8

What are the longer term complications for viral gastroenteritis?

Answer 8

Faltering growth
Irritable bowel syndrome
Lactose intolerance

Question 9

What are some complications of gastroenteritis?

Answer 9

1. Dehydration, electrolyte disturbance, AKI
2. Haemorrhagic colitis, haemolytic ureamis syndrome, thrombotic thrombocytopenic purpura
3. Reactive arthiritis
4. Toxic megacolon
5. Sepsis

Question 10

What is the key presentation of vomiting in gastroenteritis?

Answer 10

Presents with more forceful vomits, diarrhoea and possible dehydration.

Question 11

What are the key risk factors for gastroenteritis in children?

Answer 11

Age < 5yrs
Exposore to people with gastroenteritis
Lack of immunisation against rotovirus

Question 13

How is gastroenteritis spread?

Answer 13

Feaco-oral route

Question 14

How should dehydration be treated in paediatric cases with gastroenteritis?

Answer 14

No - Fluid compensation /maintenance with oral re-hydration therapy
Mild - rehydration with 50mL/Kg oral over 4 hours
Moderate - 100mL/Kg over 4hrs
Severe - 20mL/Kg over 1 hour

Question 15

What is the prognosis for viral gastroenteritis in children?

Answer 15

Typically is self-limited
Tends to last 3 to 7 days
No long-term follow-up is necessary

Question 16

What metabolic abnormality may be seen in viral gastroenteritis?

Answer 16

Metabolic acidosis