Viral gastroenteritis is a common cause of diarrhea but it is important to identify other causes that can be life threatening. Armon et al reported a guideline for managing children with acute diarrhea. The authors are from University of Nottingham, Pinderfields General Hospital and Maudsley Hospital in England.


Patient selection: child with diarrhea, with or without vomiting, age <= 14 years


Life-threatening causes of diarrhea in a child include:

(1) surgical abdomen

(2) intussusception

(3) hemolytic uremia syndrome


When to consider a diagnosis other than viral gastroenteritis in a child with diarrhea with or without vomiting:

(1) abdominal pain with tenderness, with or without guarding

(2) pallor

(3) jaundice

(4) oliguria or anuria

(5) bloody diarrhea

(6) appears systemically unwell, out of proportion to the level of dehydration

(7) shock


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