MED1011-PCL-Week2

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Patient Summary
2 y/o male presenting with vomiting, diarrhoea and lethargy which began previous day (sent home from childcare). He is uninterested in food or drink and unable to hold anything down.

Dx = **Gastroenteritis** and subsequent dehydration

__Causes__
· Viral – **Rotavirus** (leading cause among 3 – 15 month olds) and others · Bacterial – E.coli, shigella, salmonella · Parasitic – Giardia Lambia and others

__Signs / Symptoms__
· Diarrhoea · Vomiting · Stomach pains · Concentrated urine · Fever · Lethargy · Loss of skin turgor (low fluid) · Sunken fontanelles (gap in skull) of babies · Tachycardia

__Treatment__
· Need to replace lost fluid, replace ongoing losses and provide maintenance fluid (to make up for physiological fluid loss) · **Oral rehydration therapy** (OHT) – use commercially prepared oral rehydration products such as Gastrolyte, Pedialyte and Infalyte. Sugary drinks such as soft drinks and fruit juice are not recommended as they contain too many carbohydrates and not enough sodium, which may worsen diarrhoea. · Avoid anti-diarrhoea/vomiting drugs unless prescribed · Antibiotics to reduce severity and duration of symptoms (for bacterial gastroenteritis only); the main antibiotic used is Ciprofloxacin.

__Complications__
· Dehydration (may be fatal in infants) · Malabsorption of sugars (most commonly lactose) and consequent food intolerance

__Prognosis__
· Mainly self-limiting without any long term problems · Duration of 1-10 days