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Gastroenteritis (Viral)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Gastroenteritis, also called stomach flu, is inflammation of the stomach and intestines, typically resulting from a viral infection. Acute diarrhea and vomiting are most frequently infectious in origin with viral gastroenteritis being the second most common illness in the U.S. It is common in children and presents most often as diarrhea. Symptoms of acute gastroenteritis in adults are pathogen dependent and frequently include vomiting, diarrhea, abdominal and headache pain, and fever.1 Gastroenteritis can lead to dehydration, morbidity, and in some countries substantial mortality.
Paediatric Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Take a careful history, recognizing that not all vomiting and diarrhoea in children is simply due to gastroenteritis. Serious features that indicate an alternative diagnosis to ‘viral gastroenteritis’ include: Bloody diarrhoea.Vomiting bile, blood or faecal material bilious vomiting in the neonate is a surgical emergency requiring immediate surgical referral.Systemic toxicity out of proportion to the degree of dehydration.Severe abdominal pain with significant tenderness, distension or a palpable mass.
Irritable Bowel Syndrome
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
It is important to seek information about the onset of symptoms. Typically, continuation of GI symptoms after an episode of acute bacterial or viral gastroenteritis causing fever, diarrhoea, vomiting is observed in patients with post infective IBS.21 In practice, whilst some patients may have evidence of a positive stool culture, in many others with typical symptoms this evidence may be lacking. Diarrhoea is the predominant symptom in the majority of post infective IBS patients,22 and risk factors include female gender, history of fever, prolonged diarrhoea lasting for more than six days with a frequency of ten times per day, bloody stools and smoking.23–25
Understanding the relationship between norovirus diversity and immunity
Published in Gut Microbes, 2021
Lauren A. Ford-Siltz, Kentaro Tohma, Gabriel I. Parra
Human noroviruses are the leading cause of viral gastroenteritis in the modern world, and are implicated in upwards of 200,000 deaths worldwide, primarily in children from developing countries.20,21 In healthy individuals, norovirus causes acute gastroenteritis (diarrhea and vomiting) that resolves within 24–48 hours, with virus shedding typically lasting between 2 and 8 weeks in the stool.22 However, in vulnerable populations (like the elderly, malnourished children, or immunocompromised individuals), the length and severity of disease is increased. Specifically, in immunocompromised individuals, gastroenteritis symptoms and viral shedding can last months or years.23 In addition to the disease burden, norovirus presents a major impact on the global economy, with around 4.2 USD billion in direct health-care costs and an additional 60.3 USD billion in indirect costs, i.e. loss of productivity due to absenteeism of work or morbidity.24
Vaccines against gastroenteritis, current progress and challenges
Published in Gut Microbes, 2020
Hyesuk Seo, Qiangde Duan, Weiping Zhang
Progress has been also made in vaccine development for the other enteric viruses including astroviruses (Astroviridae), adenoviruses (Adenoviridae), and sapoviruses (Caliciviridae). Other Astroviridae members such as VA-Like and MLB-like astroviruses, Picornaviridae (silivirus, cosavirus), and Parvoviridae families (bocaviruses, bufaviruses) are also isolated from patients (usually in infants and children) with gastroenteritis. Several subunit vaccines have been investigated for prevention against astrovirus infections. In particular, a trivalent subunit vaccine for hepatitis E virus, norovirus, and astrovirus was generated by fusing together the dimeric P domains of the three viruses to form a tetramer.93 When intranasally administered to mice, this trivalent product induced significant neutralizing antibody responses to the P domains of all three viruses. Another subunit astrovirus vaccine candidate used the capsid protein (CP) of mink astrovirus elicited high levels of serum anti-CP antib odies and lymphoproliferation responses and also stimulated IFN-γ levels in mice.94 Importantly, it was observed that virus shedding was suppressed and clinical signs including severe diarrhea were reduced in the litters born to the immunized mink mothers when challenged with a heterogeneous astrovirus strain.94 Future human volunteer studies and clinical trials are needed to assess the efficacy of these vaccine candidates against viral gastroenteritis.
Takotsubo cardiomyopathy: a rare complication of acute viral gastroenteritis
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Ammar Ashfaq, Waqas Ullah, Shristi Khanal, Muhammad Abdullah Zain, Nishanth Thalambedu, Faisal Inayat, Muhammad Umair Atiq
Takotsubo cardiomyopathy (TCM) is characterized by transient but reversible left ventricular systolic dysfunction which resolves within a few days to weeks. Chest pain is reported as a typical presenting symptom (70% of cases) which mimics acute coronary syndrome. However, a small number of cases may be asymptomatic [4]. TCM has been identified in 1–2% of troponin positive patients suspected as having an acute myocardial infarction [5]. Acute viral gastroenteritis (AVG) is the viral-induced inflammation of the gastrointestinal tract causing vomiting, diarrhea and abdominal pain with or without fever. It usually is self-limiting and does not lead to complications. TCM predominantly occurs in post-menopausal females following, but not always, a recent emotional or physically stressful event [3]. Given the benign nature, it is rare for AVG to be associated with Takotsubo syndromes, like in our case. A literature search using different medical subject headings (MeSH) on PubMed identified only three cases of gastroenteritis-related Takotsubo syndrome [6–8]. Interestingly, patients were at the both extreme of their ages, with two elderly patients (72 and 65-year-old) and the other one only 15 months old. One of the previously reported elderly patients was male and one was female. All patients presented with diarrhea predominantly. Two reported cases had C. Diff related gastroenteritis and one had viral gastroenteritis, similar to our case. All patients had classic findings of Takotsubo syndrome, defined as apical ballooning with reduced ejection fraction. One patient with C. Diff-induced TCM expired, while the patient with AVG had a successful recovery. Our patient also has had a successful recovery with supportive management only. All cases, including our case, are summarized in Table 1.