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Diarrhoeal disease is a group of gastrointestinal syndromes characterized by multi-pathogenic and multi-factor caused by increased stools and changes in traits, which are common diseases in children, most common in children aged 6 months to 2 years, and are one of the important factors causing malnutrition and backward growth and development in children.
Most parents will think that diarrhea disease is diarrhea for a few days, after a few days it will be better, do not know, diarrhea disease is a major health killer of children, it will cause dehydration, electrolyte disorders, acute kidney failure and other manifestations, serious can be fatal, in our daily life can not be ignored.
Classic case
A boy of 2 years and 2 months was admitted to the hospital for "vomiting, 2 days of increased frequency of bowel movements, 1 day of fever, and 13 hours of no urine", and there was no special history of birth, growth and development, and past history.
Vomiting of gastric contents occurred more than 10 times before 2 days without obvious inducements, accompanied by an increase in the number of bowel movements, 4-5 times per day.
At that time, after the family gave "Huoxiang Zhengqi Water" oral administration, the vomiting was reduced compared with before, so at that time, I continued to observe at home, 1 day ago there was fever, the body temperature was up to 39.4 ° C, and the heat peak dropped after giving oral "Merrill Lynch" at home, but it was found that the child's mental reaction was not good, he always slept, and he could not eat later my hospital.
When our attending doctor found out about the child's condition, his first reaction was that the child had diarrhea and was dehydrated, and immediately recommended hospitalization.
The child arrived at the inpatient department at about 1:30 a.m., I found that the child had a history of vomiting, increased frequency of defecation for 2 days, there had been no urination for 13 hours, the child was called no, the skin was very dry, the orbit was sunken, the ends of the hands and feet were cold, the body temperature was measured at 38 ° C, and there was bloating, my first reaction was the same as the emergency doctor, this child was diarrhea and severe dehydration.
When I saw the child's situation, I immediately asked the nurse to expand the normal saline, and at the same time checked the blood gas analysis, electrolyte and other blood tests, B ultrasound examination, electrocardiogram examination and monitoring, rehydration and other treatment.
When our medical staff gave the child an injection, the child did not hum much, hurriedly informed the child's parents of the condition, the grandparents were surprised, said to me, my child is just diarrhea, is it as serious as you say? I brought up the child, and I know his situation.
ECG monitoring suggests that the heart rate is 165 times / min, T wave is high and sharp, breathing is 42 times / min, soon the blood gas analysis results come out, the child's blood potassium is only 2.2 mmol / l (severe hypokalemia, normal value 3.5-5.5 mmol / l), as well as the performance of metabolic acidosis, when I gave the child a critical illness notification, and to give the child a deep vein puncture rehydration and other operations, if necessary, blood purification.
At this time, the parents were really afraid, my mother was already crying there, my father was also crouching in the corner with his head in his arms, and grandma said that the doctor you want to save my grandson.
I gave the child a diagnosis and treatment at the same time, carefully comforted the family, from admission to the morning at eight o'clock in the morning, a total of 1050ml of liquid into the child, the child's spirit slowly improved, the urine slowly increased, the ends of the limbs also touched warm, the eye socket is still slightly sunken, the skin elasticity is better than before, the blood gas analysis blood potassium also reached 2.7mmol / l, and the heart rate and breathing have also improved significantly.
So far, the back checked the rotavirus to suggest positive, considering the vomiting and diarrhea caused by rotavirus infection, causing severe dehydration, severe hypokalemia, acute renal failure and other problems, the subsequent treatment was very smooth, after rehydration, adjustment of the intestine and other treatment, the child was successfully discharged after 3 days.
What is rotavirus enteritis?
Rotavirus enteritis is an acute infectious gastrointestinal disease caused by rotavirus, a common type in children, common in autumn and winter, also known as "autumn diarrhea". The disease is mainly transmitted by the fecal-oral route and is mainly common in children under 5 years of age, accounting for 40% to 60% of pediatric diarrhea.
What are the symptoms of rotavirus?
Fever, vomiting, diarrhea, and upper respiratory tract symptoms are common, and most are absent from obvious symptoms of infection and poisoning. Vomiting is usually 1 to 2 days after the beginning of the disease, but can precede diarrhea, fever can be moderate to high fever, and persistent high fever can cause febrile seizures.
The disease causes the greatest harm to children is dehydration and electrolyte disturbances, and in severe cases can lead to death. The disease can also cause secondary infections, viral encephalitis, intussusception, myocarditis and other diseases.
How is rotavirus enteritis treated?
At present, there is no specific drug, the disease is a self-healing disease, generally maintained for 3-8 days. The main treatment is to cool down, replenish water, maintain electrolyte acid-base balance and other treatments, but also can be given microecological preparations, antiemetic drugs, zinc supplementation, diarrhea milk powder and other treatments.
Vaccines for rotavirus enteritis are currently available and are recommended for children aged 6 months to 3 years.
About the author
Ye Guojing
The Third People's Hospital of Huizhou City
Associate Physician, Department of Pediatrics
Introduction: Bachelor degree, graduated from Guangdong Medical College in 2009, majoring in clinical medicine, has more than ten years of work experience, the professional direction is pediatric intensive care, in 2019, he studied in the pediatric intensive care unit of Guangdong Provincial People's Hospital for half a year, in 2021, he studied in the pediatric intensive care of Zhujiang Hospital of Southern Medical University for 3 months, and has a certain achievement in children's critical care and respiratory.