A pediatric patient with acute diarrhea should have a medical evaluation if certain findings or risk factors are present.


Indications for a medical evaluation of a child with acute diarrhea:

(1) age < 6 months

(2) body weight < 8 kg (17.6 pounds)

(3) history of prematurity

(4) history of a significant chronic comorbid condition

(5) presence of significant concurrent illness

(6) fever (>= 38.0°C if < 3 months; >= 39°C if 3-36 months)

(7) visible blood in stool

(8) high output diarrhea (frequent episodes with large volumes of stool)

(9) persistent vomiting

(10) signs of severe dehydration (sunken eyes, dry membranes, oliguria or anuria)

(11) change in mental status (irritable, apathetic, lethargic)

(12) failure to respond or suboptimal response to oral rehydration therapy

(13) inability of the caregiver to administer adequate oral rehydration therapy


A child without any of these findings should be adequately managed on appropriate oral rehydration therapy.


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