Rotavirus

Background

  • Leading cause of acute gastroenteritis worldwide
    • 95% of children in US have had rotavirus by age 5
  • Fecal-oral transmission
  • Seasonal: more cases in late winter/early spring
  • Vaccination of infants recommended by CDC[1]

Clinical Features

  • Low grade fever
  • Nausea/Vomiting (typically worse in the first 1-2 days)
  • Diarrhea, watery, copious
  • Rare complications:
    • Hepatitis
    • Pneumonitis
    • Encephalopathy

Differential Diagnosis

Evaluation

  • Diagnosis usually clinical
  • Assess hydration status
    • Cap refill, skin turgor, respiratory rate
    • Pediatric signs of dehydration: prolonged cap refill, dry mucous membranes, no tears, abnormal overall appearance
  • Consider stool labs if:

Management

  • Rehydration (PO preferred, especially in children)
    • 30mL(1oz)/kg/hr
  • Antiemetic (e.g. Ondansetron 0.15mg/kg/dose IV/PO)

Disposition

  • Most can be discharged
  • Admit
    • Unable to tolerate PO
    • Hemodynamic instability
    • Significant comorbidities

See Also

External Links

References

Authors:

Claire