Rotavirus: Difference between revisions
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==Background== | ==Background== | ||
*Leading cause of [[acute gastroenteritis]] worldwide | |||
*Leading cause of [[Special:MyLanguage/acute gastroenteritis|acute gastroenteritis]] worldwide | |||
**95% of children in US have had rotavirus by age 5 | **95% of children in US have had rotavirus by age 5 | ||
*Fecal-oral transmission | *Fecal-oral transmission | ||
*Seasonal: more cases in late winter/early spring | *Seasonal: more cases in late winter/early spring | ||
*Vaccination of infants recommended by CDC<ref>https://www.cdc.gov/rotavirus/vaccination.html</ref> | *Vaccination of infants recommended by CDC<ref>https://www.cdc.gov/rotavirus/vaccination.html</ref> | ||
==Clinical Features== | ==Clinical Features== | ||
*Low grade [[fever]] | |||
*[[Nausea/Vomiting]] (typically worse in the first 1-2 days) | *Low grade [[Special:MyLanguage/fever|fever]] | ||
*[[Diarrhea]], watery, copious | *[[Special:MyLanguage/Nausea/Vomiting|Nausea/Vomiting]] (typically worse in the first 1-2 days) | ||
*[[Special:MyLanguage/Diarrhea|Diarrhea]], watery, copious | |||
*Rare complications: | *Rare complications: | ||
**Hepatitis | **[[Special:MyLanguage/Hepatitis|Hepatitis]] | ||
**Pneumonitis | **[[Special:MyLanguage/Pneumonitis|Pneumonitis]] | ||
**Encephalopathy | **[[Special:MyLanguage/Encephalopathy|Encephalopathy]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{Nausea and vomiting DDX}} | |||
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==Evaluation== | ==Evaluation== | ||
*Diagnosis usually clinical | *Diagnosis usually clinical | ||
*Assess hydration status | *Assess hydration status | ||
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*Consider stool labs if: | *Consider stool labs if: | ||
**>10 stools in previous 24hr | **>10 stools in previous 24hr | ||
**[[Traveler's diarrhea|Travel to high-risk country]] | **[[Special:MyLanguage/Traveler's diarrhea|Travel to high-risk country]] | ||
**Bloody stool | **[[Special:MyLanguage/rectal bleeding|Bloody stool]] | ||
**Persistent diarrhea | **Persistent [[Special:MyLanguage/diarrhea[[ | ||
==Management== | ==Management== | ||
*Rehydration (PO preferred, especially in children) | |||
*[[oral rehydration therapy|Rehydration]] (PO preferred, especially in children) | |||
**30mL(1oz)/kg/hr | **30mL(1oz)/kg/hr | ||
* | *[[Special:MyLanguage/Antiemetics|Antiemetics]] (e.g. [[Special:MyLanguage/Ondansetron|Ondansetron]] 0.15mg/kg/dose IV/PO) | ||
==Disposition== | ==Disposition== | ||
*Most can be discharged | *Most can be discharged | ||
*Admit | *Admit | ||
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**Hemodynamic instability | **Hemodynamic instability | ||
**Significant comorbidities | **Significant comorbidities | ||
==See Also== | ==See Also== | ||
*[[Nausea and Vomiting]] | |||
*[[Acute gastroenteritis (peds)]] | *[[Special:MyLanguage/Nausea and Vomiting|Nausea and Vomiting]] | ||
*[[Acute gastroenteritis]] | *[[Special:MyLanguage/Acute gastroenteritis (peds)|Acute gastroenteritis (peds)]] | ||
*[[Dehydration]] | *[[Special:MyLanguage/Acute gastroenteritis|Acute gastroenteritis]] | ||
*[[Acute diarrhea]] | *[[Special:MyLanguage/Dehydration|Dehydration]] | ||
*[[Special:MyLanguage/Acute diarrhea|Acute diarrhea]] | |||
==External Links== | ==External Links== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] [[Category:GI]] | [[Category:ID]] [[Category:GI]] | ||
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Latest revision as of 23:57, 4 January 2026
Background
- Leading cause of acute gastroenteritis worldwide
- 95% of children in US have had rotavirus by age 5
- Fecal-oral transmission
- Seasonal: more cases in late winter/early spring
- Vaccination of infants recommended by CDC[1]
Clinical Features
- Low grade fever
- Nausea/Vomiting (typically worse in the first 1-2 days)
- Diarrhea, watery, copious
- Rare complications:
Differential Diagnosis
Nausea and vomiting
Critical
Emergent
- Acute radiation syndrome
- Acute gastric dilation
- Adrenal insufficiency
- Appendicitis
- Bowel obstruction/ileus
- Carbon monoxide poisoning
- Cholecystitis
- CNS tumor
- Electrolyte abnormalities
- Elevated ICP
- Gastric outlet obstruction, gastric volvulus
- Hyperemesis gravidarum
- Medication related
- Pancreatitis
- Peritonitis
- Ruptured viscus
- Testicular torsion/ovarian torsion
Nonemergent
- Acute gastroenteritis
- Biliary colic
- Cannabinoid hyperemesis syndrome
- Chemotherapy
- Cyclic vomiting syndrome
- ETOH
- Gastritis
- Gastroenteritis
- Gastroparesis
- Hepatitis
- Labyrinthitis
- Migraine
- Medication related
- Motion sickness
- Narcotic withdrawal
- Thyroid
- Pregnancy
- Peptic ulcer disease
- Renal colic
- UTI
Evaluation
- Diagnosis usually clinical
- Assess hydration status
- Cap refill, skin turgor, respiratory rate
- Pediatric signs of dehydration: prolonged cap refill, dry mucous membranes, no tears, abnormal overall appearance
- Consider stool labs if:
- >10 stools in previous 24hr
- Travel to high-risk country
- Bloody stool
- Persistent [[Special:MyLanguage/diarrhea[[
Management
- Rehydration (PO preferred, especially in children)
- 30mL(1oz)/kg/hr
- Antiemetics (e.g. Ondansetron 0.15mg/kg/dose IV/PO)
Disposition
- Most can be discharged
- Admit
- Unable to tolerate PO
- Hemodynamic instability
- Significant comorbidities
See Also