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Diagnosis and investigations in child with gastroenteritis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Mild dehydration which is being treated with oral fluids requires no further investigation.

Diagnosis and investigations:

  • a stool sample is not a mandatory investigation in case of diarrhoea and vomiting in children
    • stool microbiological investigations should be performed if:
    • septicaemia is suspected or
    • there is blood and/or mucus in the stool or
    • the child is immunocompromised
    • in other circumstances when stool microbiological investigations should be considered include:
      • the child has recently been abroad or
      • the diarrhoea has not improved by day 7 or
      • there is uncertainty about the diagnosis of gastroenteritis
  • blood cultures
    • if giving antibiotic therapy then perform a blood culture
  • blood biochemical testing is not routinely indicated
    • measurement of plasma sodium, potassium, urea, creatinine and glucose concentrations is indicated if:
      • intravenous fluid therapy is required or
      • there are symptoms and/or signs that suggest hypernatraemia
  • venous blood acid-base status and chloride concentration is indicated if shock is suspected or confirmed

If the diarrhoea is bloody then a full blood count, blood cultures and urea and electrolytes should be performed. If the haemoglobin is low then haemolytic uraemic syndrome should be considered and a film should be asked for to see if there are fragmented red blood cells.

Reference:


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