Acute gastroenteritis
Background
- Blood diarrhea suggests bacterial etiology
- Viral AGE usually lasts <7d
- Do not dx isolated vomiting as AGE
Diagnosis
- Vomiting/diarrhea
- Crampy/diffuse abdominal pain
Work-Up
- Assess hydration status
- Cap refill, skin turgor, resp rate
- Consider stool labs if:
- >10 stools in previous 24hr
- Travel to high-risk country
- Fever
- Bloody stool
- Persistent diarrhea
DDx
Species | Onset | Symptoms | Transmission |
---|---|---|---|
Salmonella | 6-72 hours |
|
|
Shigella | 1-3 days |
|
|
Yersinia | 1-5 days |
|
|
Campylobacter | 1-7 days |
|
|
C. Dif | 10 days |
|
|
Entamoeba | 1-11 weeks |
|
|
Treatment
- Oral rehydration therapy
- 30mL(1oz)/kg/hr
- Antiemetic
- Ondansetron 0.15mg/kg/dose IV/PO
- Antibiotics
- Only consider in pts w/ invasive infection
- Shigella, campylobacter, E. coli, yersinia, vibrio
- Bloody stool w/ mucus and fever
- NOT indicated for E. coli O157:H7
- NOT routinely indicated for salmonella
- Exceptions: SCD, IBD, <3mo
- Azithromycin (able to tolerate PO)
- Ceftriaxone (parenteral)
- Only consider in pts w/ invasive infection
Disposition
See Also
Source
Tintinalli