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Rotavirus
From WikEM
Contents
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:
- >10 stools in previous 24hr
- Travel to high-risk country
- Bloody stool
- Persistent diarrhea
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
