Infantile gastroenteritis presentation widely varies depending on its etiology and severity. In viral gastroenteritis, most often caused by rotavirus, there is low fever, vomiting, and water-like stools. Most rotavirus patients are younger than 2 years [1]. Blood is absent in the fecal matter.

Severe abdominal pain and bloody diarrhea point to a bacterial etiology.

The existence of dehydration should be thoroughly assessed. Important clinical indicators are low blood pressure, tachycardia, thready pulse, significant weight loss, dry mucous membranes, and oliguria. The consciousness state may be decreased in severely affected infants.

The physician should inquire about the types of food the patient has ingested, which may point to a specific pathogen: dairy products may contain Staphylococcus, Campylobacter, Listeria or Salmonella species. Meat can be infected by Clostridium perfringens, Aeromonas, Staphylococcus and Salmonella or Campylobacter species, while seafood intake may lead to astrovirus, Vibrio, Aeromonas or Plesiomonas species infection. If symptoms occur sooner than 6 hours after ingestion, a preformed toxin, like those produced by Bacillus or Staphylococcus should be suspected. Nosocomial infection of various types has also been documented [2].

Aeromonas induces acute watery diarrhea or a more severe, cholera-like illness, with blood present in the stool [3]. Bacillus cereus causes precocious emetic syndrome that usually resolves within 24 hours [4] and watery diarrhea accompanied by severe cramps [5]. Campylobacter infection is characterized by a pre-diarrhea period, with fever, myalgia and abdominal pain [6]. Clostridium difficile may be complicated by pseudomembranous colitis [7]. Escherichia coli leads to enteritis that may progress to hemorrhagic colitis and hemolytic uremic syndrome [8]. Diarrhea usually lasts for 1 to 3 days and is accompanied by headache, dizziness, lymphadenopathy, rash and myalgia [9]. Nontyphoidal Salmonella infection is characterized by diarrhea that usually lasts less than a week, but may lead to extraintestinal complications, such as urinary tract infections, osteomyelitis or arthritis. Salmonella typhi is the etiological agent of typhoid fever, a condition with diarrhea, vomiting, anorexia, fever, headaches and rose spots. Bloody stools may be present both in Salmonella [10] and Shigella patients [11]. Cholera is described as afebrile, watery, painless diarrhea. A more severe form, cholera gravis may give rise to an immense liquid loss which rapidly progresses to severe dehydration and death [12]. Yersinia enterocolitica can be the causative agent of terminal ileitis and mesenteric lymphadenitis and may mimic appendicitis [13]. Complaints may persist up to one year in Yersinia infection [14]. The physician should inquire about associated symptoms of parasitic infections, like anal pruritus, that may be accompanied by diarrhea.

• Diarrhea

  Bacillus cereus causes precocious emetic syndrome that usually resolves within 24 hours and watery diarrhea accompanied by severe cramps. Campylobacter infection is characterized by a pre-diarrhea period, with fever, myalgia and abdominal pain. [symptoma.com]

  Diarrhea occurred in 41 of 165 infants (25%), with probable nosocomial acquisition in 26 patients. Two infants each had two episodes of diarrhea, and one had three. A putative pathogen was found in 31 of 45 case episodes (69%). [jpeds.com]

  Blood samples were extracted from each child with diarrhea, in the acute and convalescence period, complement fixing antibodies being measured with antigen of Nebraska Calf Diarrhea Virus (NCDV). [nature.com]

  Part III examines the epidemiological relationship between malnutrition and chronic diarrhea in infants and children. Part IV focuses on the diagnosis and dietary and pharmacological management of chronic diarrhea. [books.google.de]

• Vomiting

  […] by the picture of vomiting and diarrhea, in addition to the appearance of the fever produced by the viral character of the infantile gastroenteritis. [parenthotline.net]

  The occurrence of vomiting is controlled by the vomiting center in the central nervous system (brain) us. Vomiting occurs when there are certain conditions that stimulate the vomiting center. [nanda-health.blogspot.com]

  […] of young children (6 months-12 years) that is especially widespread during winter, caused by strains of rotavirus (family Reoviridae); the incubation period is 2-4 days, with symptoms lasting 3-5 days, including abdominal pain, diarrhea, fever, and vomiting [medical-dictionary.thefreedictionary.com]

  She has been vomiting and having severe diarrhea for 2... 36-year-old client was admitted with gastroenteritis. She has been vomiting and having severe diarrhea for 2 days. She is very weak. [homeworklib.com]

• Nausea

  Imbalanced Nutrition, Less Than Body Requirements related to nausea and vomiting. Intervention Diagnosis 1 Imbalanced Nutrition, Less Than Body Requirements related to nausea and vomiting. [free-nursingcareplan.blogspot.com]

  Other symptoms of gastroenteritis include: vomiting nausea stomach cramps headaches a high temperature (fever) of 38–39C (100.4–102.2F) Symptoms of dehydration include: tiredness apathy (a lack of emotion or enthusiasm) dizziness nausea headaches muscle [care-plan.blogspot.com]

  The feeling that one is about to vomit is called nausea; it often precedes, but does not always lead to vomiting. Antiemetics are sometimes necessary to suppress nausea and vomiting. [en.wikipedia.org]

  […] symptoms were there, but you were ignoring them. you have to deal in facts. because you assumed "taking medications with empty stomach causes irritation in her gastric lining that make her feel nauseated and was like to vomit" you missed a valuable clue--nausea [allnurses.com]

  The symptoms that usually appear with the infantile gastroenteritis are similar to which occurs in adults with the same virus, that is, that our son can suffer nausea, vomiting, fever, dizziness, abdominal pain and episodes of diarrhea. [parenthotline.net]

• Hyperactive Bowel Sounds

  Hyperactive bowel sounds. Loose stools. Urgency. Desired Outcomes Client will have a negative stool culture. Client will pass soft, formed stool no more than 3 x a day. [nurseslabs.com]

  Associated clinical manifestations are nausea, vomiting, fever anorexia, distention, tenesmus (straining on defecation), and borborygmi (hyperactive bowel sounds). [rnpedia.com]

• Dyspepsia

  Symptoms of Gastritis : Upper abdominal pain or dyspepsia, Nausea, Vomiting, Belching, Acid reflux, Bloating, Indigestion, Loss of appetite, Bad breath, Feeling of fullness in upper abdomen, Concentrated burning sensation in upper abdomen, Passing of [nandadiagnosis.blogspot.com]

  Cushing ulcer; Dieulafoy's lesion; Dyspepsia; Pyloric stenosis; Achlorhydria; Gastroparesis; Gastroptosis; ... Read Article Gastrointestinal Nursing - BMSU Gastrointestinal nursing can be defined as the nursing and includes nursing diagnosis. [nursingdiagnosiszabude.blogspot.com]

In cases where physical examination suggests a bacterial, protozoal or parasitic infection, laboratory tests are required in order to elucidate the etiology. In all situations where dehydration signs are observed, the physician should evaluate the gravity of the condition by ordering complete blood cell count, serum electrolytes, urea, and creatinine.

Clinical judgment indicates what tests may be necessary for a specific patient. Giardia lamblia is identified by enzyme immunoassay. Rapid antigen stool testing may highlight the presence of rotavirus, while polymerase chain reaction is used in calicivirus infection. Human astrovirus genotyping is possible in selected cases [15]. The stool should be examined for parasite ova and larvae [16], as well as leukocytes, that signify enteroinvasive infection. Bacterial cultures are extremely valuable [17] and should always be performed if the patient is febrile. Cultures for Campylobacter, Salmonella, and Shigella should be obtained if white or red blood cells are identified in the stool. Escherichia coli is identified if the stool is cultured on a specific environment such as a chromogenic media [18]. This is method valuable in Yersinia [19], Salmonella [20] and Vibrio [21] species, as well. A blood agar plate is useful for the detection of Aeromonas spp., Vibrio spp. and Plesiomonas spp. Campylobacter should be cultured on blood-free charcoal-cefoperazone-deoxycholate agar or Skirrow medium [22] or it can be identified using its characteristic Gram stain morphology. Antibiotic susceptibility testing is indicated in infants younger than 6 months or immunocompromised children, as well as those with prolonged evolution.

If the diarrhea is considered to be part of an ulcerative colitis or Crohn's disease, a colonoscopy may be indicated. This procedure sometimes visualizes pseudomembranes in Clostridium difficile infection. If this microorganism is identified, the physician should keep in mind and monitor the risk of developing toxic megacolon [23], intestinal perforation [24], renal failure or septic shock.

• Rhythmic Slowing

  In only one patient with grouped seizures an ictal electroencephalogram was performed and left rhythmic slow waves were observed. A cerebral CT scan was performed in 14 patients, and cerebral MRI was performed in nine patients. [seizure-journal.com]

• Complement Fixing Antibody

  Abstract Complement-fixing immunoglobulin M antibody to infantile gastroenteritis virus (a rotavirus) was detected with highest sensitivity when the antibody-antigen-complement mixture was incubated at 37 degrees C for 1 h prior to the addition of sensitized [ncbi.nlm.nih.gov]

  Blood samples were extracted from each child with diarrhea, in the acute and convalescence period, complement fixing antibodies being measured with antigen of Nebraska Calf Diarrhea Virus (NCDV). [nature.com]

After 8 hours on parenteral treatment, the child was given oral solution, either glucose-electrolyte solution or milk formula in ¼ dilution. [paediatricaindonesiana.org]

We recommend 1 day of treatment with low-dose carbamazepine as the first-line treatment for BISMG. The unnecessary use of AEDs for BISMG should be avoided after the acute phase because seizures in BISMG rarely recur. [jstage.jst.go.jp]

Abstract BACKGROUND: Standard treatment of infants who are dehydrated as a result of acute gastroenteritis is to administer oral rehydration therapy (ORT). [bjgp.org]

In 8 patients with CwG due to norovirus, treatment with the anticonvulsant carbamazepine (serum level 5.4 +/- 1.1 mg/dl) significantly shortened duration of seizures as compared to treatment with phenobarbital. [pediatricneurologybriefs.com]

The prognosis is good. doi: 10.3969/j.issn.1672-6731.2014.03.019 Keywords Gastroenteritis; Seizures, febrile; Encephalitis, viral; Child [cjcnn.org]

The interictal EEG is normal, response to anticonvulsants is variable, often poor, but the prognosis is favorable. The entity is reported mainly in Asia, and outbreaks are rare in the US and Europe. [pediatricneurologybriefs.com]

They are characterized by brief generalized seizure or seizures in cluster, normal laboratory findings and good prognosis. We believe that individualized approach is needed in the management of rotavirus gastroenteritis with afebrile convulsion. [kjp.or.kr]

Prognosis of the neurological complications of acute hypernatraemia. Lancet. 1967 Dec 30;2(7531):1385–1389. [PubMed] [Google Scholar] Ramsay AM. Acute infective diarrhoea. Br Med J. 1968 May 11;2(5601):347–350. [ncbi.nlm.nih.gov]

Prognosis is very poor in secondary PCL. [cancernetwork.com]

Severe abdominal pain and bloody diarrhea point to a bacterial etiology. The existence of dehydration should be thoroughly assessed. [symptoma.com]

No wardwide etiologic pattern was evident, but minirotavirus or calicivirus or both were associated with diarrhea in 20 patients, accompanied by vomiting in 15 of these infants. [jpeds.com]

This finding should provide additional evidence for the etiologic role of calicivirus in acute infantile gastroenteritis. [ncbi.nlm.nih.gov]

The difficulties in assessing the value of chemotherapeutic agents in such a disease as infantile gastroenteritis, of varied and as yet not thoroughly understood etiology, are not unexpected. [jamanetwork.com]

The concussed data on various etiological agents of gastroenteritis was limited in the journals. This article is an attempt to put forth the varied etiology of gastroenteritis as a disease. [atmph.org]

Serological studies of a diagnostic but not epidemiological nature may also be performed with equal facility by this same test scheme using highly purified IGV antigen derived from stool. [ncbi.nlm.nih.gov]

European Journal of Epidemiology, Vol. 21, Issue. 2, p. 161. CrossRef Google Scholar Desselberger, Ulrich Wolleswinkel-van den Bosch, Judith Mrukowicz, Jacek Rodrigo, Carlos Giaquinto, Carlo and Vesikari, Timo 2006. [cambridge.org]

Epidemiology and clinical features of rotavirus and norovirus infection among children in Ji'nan, China. Virol J, 2013; 10(1): 302. Chen CJ, Lartey B,A gbemabiese C, Armah G et al. The Epidemiology of Noroviruses in Ghana. [ejmm.edu.eg]

Lesson Print Pathophysiology Abdominal pain can be a very minor issue that is easily resolved, or a medical emergency. There are many different things that can cause abdominal pain, whose pathophysiology can differ widely. [nursing.com]

[…] nursing process when care planning. step 1 assessment - collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology [allnurses.com]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 16. Updated by: Michael M. [medlineplus.gov]

[citation needed] Pathophysiology Receptors on the floor of the fourth ventricle of the brain represent a chemoreceptor trigger zone, known as the area postrema, stimulation of which can lead to vomiting. [en.wikipedia.org]

Pathophysiology The 2 primary mechanisms responsible for acute gastroenteritis are: There is damage to the villous brush border of the intestine, causing malabsorption of intestinal contents and leading to an osmotic diarrhea. [nurseslabs.com]

Centers for Disease Control and Prevention. Advisory Committee Recommends New Vaccine to Prevent Rotavirus. [Full Text]. Centers for Disease Control and Prevention. [medscape.com]

Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization [books.google.de]

To prevent dehydration & maintain hydration status. Provide frequent oral care To prevent from dryness Administer Intravenous fluids as prescribed To deliver fluids accurately and at desired rates. Determine effects of age. [rnpedia.com]

Prevent infection Abdominal pain may have been caused by a pathogen (gastroenteritis, for example). It is essential to promote adequate hand hygiene and infection prevention to prevent the spread to others or preventing the issue from resolving. [nursing.com]

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