Gastroenteritis

• Preferred terms = acute diarrhoea and vomiting or acute intestinal infection

• Commonest pathogen = rotavirus

• Commonest bacteria = Campylobacter jejuni

  • fever

  • severe abdominal pain

  • diarrhoea (may be bloody)

• Protozoal infection = Giardia lamblia

• Other pathogens

  • Rotavirus

  • Picornavirus

  • Small round viruses

  • Corona-like viruses

  • Adenovirus

  • Campylobacter jejuni

  • Non-typhoid salmonellae

  • Shigellae

  • Yersiniae

  • Staphylococci

  • Bacillus cereus

  • Clostridia

  • Vibrio parahaemolyticus

  • Virbrio cholerae

  • Eschericia coli

  • Bacteroides fragilis

  • Aeromonas

  • Pseudomonas

  • Entamoeba histolytica

  • Giardia lamblia

  • Cryptosporidium parvum

• Other causes

  • Systemic infection

    • Urinary tract infections

    • Septicaemia

    • Meningitis

    • respiratory tract infections

  • Surgical

    • appendicitis

    • intussusception

    • Hirschsprung disease

    • pyloric stenosis

  • Metabolic

    • diabetic ketoacidosis

    • congenital adrenal insufficiency

  • Misc.

    • antibiotic-associated

    • cystic fibrosis

    • coeliac disease

    • chronic inflammatory bowel disease

    • immunodeficiency

    • Kawasaki disease

    • laxatives

    • cow's milk protein intolerance

    • enterocolitis

    • poisoning

    • toddler diarrhoea

    • toxic shock syndrome

Signs / Symptoms

• diarrhoea +/- vomiting
  • +/- blood
• dehydration
  • decreased skin turgor
  • sunken eyes
  • sunken fontanelle
  • suppression tear / saliva formation
  • hypovolaemic shock

Management

• oral rehydration therapy
  • 60mM sodium
  • 20 mM potassium
  • 100 mM glucose
• IV fluids if neccessary
• IV antibiotics if systemically unwell

Complications

• Hypernatraemic dehydration
  • cerebral haemorrhage
  • cerebral oedema
  • death
  • brain damage

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