Acute infectious diarrhea in children.
Acute infectious enteritis (including gastroenteritis) remains one of the commonest causes of death among infants and children in developing countries ( 1). It is most commonly due to viral infection (e1).
In Europe, most cases take a mild to moderately severe course, and fatal outcomes are extremely rare. Nonetheless, acute enteritis is a common cause of hospitalization in Germany and leads to high expenditures on health care, not least because of nosocomial infection ( 2).
The younger the child, the greater the risk that fluid and electrolyte losses will lead to dehydration. The type of dehydration-isotonic, hypotonic, or hypertonic-is independent of the causative organism. Fluid losses resulting from diarrhea and vomiting can be as high as three times the circulating blood volume (80-125-250 mL per kg body weight per day). In order to keep the blood volume constant, the body extracts fluid from the intracellular space, leading to dehydration. Complications and hospitalization can usually be prevented by the early and adequate oral administration of a rehydration solution (glucose-electrolyte solution) and normal food for the child's age.
The evidence-based guidelines of the ESPGHAN ( 3), the GPGE guidelines ( 4), Cochrane analyses ( 5-7), and a selective review of the literature are the basis of this article.
The learning aims for the reader are:
— Acquiring knowledge of the causes, principal manifestations, complications, and basic diagnostic evaluation of acute infectious diarrheal illnesses in childhood
— Being able to state the therapeutic measures to be taken in ambulatory care (the doctor's office and the walk-in emergency service)
— Taking note of the possibilities for prevention.