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Dtsch Arztebl Int. 2009 Aug;106(33):539-47; quiz 548. doi: 10.3238/arztebl.2009.0539. Epub 2009 Aug 14.

Acute infectious diarrhea in children.

Author information

1
Abteilung für Pädiatrische Gastroenterologie und Hepatologie, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München. Sibylle.Koletzko@med.uni-muenchen.de

Abstract

BACKGROUND:

Acute infectious enteritis is one of the more common childhood diseases worldwide, especially in the first three years of life. Every year, in Germany, one in six children under age 5 is taken to a physician at least once because of infectious diarrheal disease. 10% of the children presenting with rotavirus infection are admitted to hospital. The existing national and international recommendations for the treatment of acute infectious diarrheal disease are inadequately followed, despite the high level of evidence on which they are based.

METHODS:

Selective literature search based on national and international guidelines.

RESULTS AND CONCLUSIONS:

The therapeutic goal is to replace the fluid and electrolyte losses resulting from diarrhea and vomiting. The administration of a hypotonic oral rehydration solution (ORS) is indicated to treat impending dehydration (infants aged up to 6 months with diarrhea and/or more than 8 watery stools in the last 24 hours and/or more than 4 episodes of vomiting in the last 24 hours), or when mild or moderate dehydration is already present. Oral rehydration with ORS given in frequent, small amounts over 3-4 hours is successful in more than 90% of cases. Regular feeding can be begun immediately afterward. Laboratory testing of blood or stool is usually unnecessary. Children who can be rehydrated orally or through a nasogastric tube should not be given intravenous fluids.

KEYWORDS:

diarrhea; gastroenteritis; pediatric disease; rotavirus; vomiting

Comment in

PMID:
19738921
PMCID:
PMC2737434
DOI:
10.3238/arztebl.2009.0539
[Indexed for MEDLINE]
Free PMC Article

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