Diarrhea, vomiting and fever in a child

In children, regardless of age, high fever, nausea and vomiting are very alarming symptoms, indicating that seeking medical attention should not be delayed. Frequent vomiting can cause dehydration of body tissues. Moreover, the rate at which children lose water directly depends on their age. The main task of parents in such cases is to prevent the development of the disease. A child with fever with nausea and vomiting should be alerted.

The child has vomiting, diarrhea and fever

Elevated body temperature in childhood is in the vast majority of cases associated with viral infections, and primarily with ARVI. But there are other diseases that can lead to an increase in temperature and are accompanied by acute and additional symptoms such as diarrhea and vomiting. Parents are often frightened, for example, by the following situations: diarrhea and fever in a child, fever and vomiting in a child, vomiting and diarrhea and fever in a child , or vomiting and diarrhea in a child with fever of 38 degrees.
Even before reaching adolescence, children become familiar with the causative agents of many diseases. Timely vaccination protects against the most dangerous ones. And yet, despite vaccinations and measures to strengthen the immune system, the number of colds alone can reach six each year. But this still gives reason to suspect that any rise in temperature in a child is the first sign of a cold. If there is a combination with other specific symptoms, for example, vomiting and diarrhea in a child with fever or a child with high fever and diarrhea, then this may indicate completely different diseases. It should also be taken into account that known colds can cause such “indirect and non-main” symptoms as vomiting, diarrhea (with fever) in a child, since the functioning of the gastrointestinal tract and gall bladder (background symptoms) is disrupted.

Enterovirus infection in children: symptoms and treatment (memo for parents)

Enteroviral infections–

This is a group of diseases that are caused by several types of viruses. The disease is caused by Coxsackie viruses, polioviruses and ECHO (ECHO).

After an enterovirus infection, persistent lifelong immunity is formed, however, it is serospecific. This means that immunity is formed only to the serological type of virus that the child has had and does not protect him from other varieties of these viruses. Therefore, a child can get sick with enterovirus infection several times during his life. Also, this feature does not allow us to develop a vaccine to protect our children from this disease. The disease is seasonal: outbreaks of the disease are most often observed in the summer-autumn period.

Causes of enterovirus infection.

Infection occurs in several ways. Viruses can enter the environment from a sick child or from a child who is a virus carrier. Virus carriers do not have any manifestations of disease, but the viruses are in the intestines and are released into the environment with feces. This condition can be observed in children who have been ill after clinical recovery, or in children in whom the virus entered the body, but was unable to cause illness due to the child’s strong immunity. Virus carriage can persist for 5 months.

Once in the environment, viruses can persist for quite a long time, as they tolerate adverse effects well. Viruses are well preserved in water and soil, can survive for several years when frozen, are resistant to the action of disinfectants (when exposed to solutions of high concentrations of phenol, chlorine, formaldehyde, viruses begin to die only after three hours), but are susceptible to high temperatures (at when heated to 45ºС they die in 45-60 seconds).

How is enterovirus infection transmitted?

The transmission mechanism can be airborne (when sneezing and coughing with droplets of saliva from a sick child to a healthy one) and fecal-oral if personal hygiene rules are not observed. Most often, infection occurs through water, when drinking raw (not boiled) water. It is also possible to infect children through toys if children put them in their mouths. Children aged 3 to 10 years are most often affected. Breastfed children have immunity in their bodies, received from the mother through breast milk, however, this immunity is not stable and quickly disappears after stopping breastfeeding.

Symptoms of enterovirus infection.

Viruses enter the body through the mouth or upper respiratory tract. Once in the child’s body, the viruses migrate to the lymph nodes, where they settle and begin to multiply. The further development of the disease is associated with many factors, such as virulence (the ability of the virus to resist the body’s protective properties), tropism (the tendency to infect individual tissues and organs) of the virus and the state of the child’s immunity.

Enterovirus infections have both similar and different manifestations, depending on the type and serotype. The incubation period (the period from the virus entering the child’s body until the first clinical signs appear) is the same for all enterovirus infections - from 1 to 10 days (usually 2-5 days).

The disease begins acutely - with an increase in body temperature to 38-39º C. The temperature most often lasts 3-5 days, after which it drops to normal numbers. Very often, the temperature has a wave-like course: the temperature lasts for 2-3 days, after which it decreases and remains at normal levels for 2-3 days, then rises again for 1-2 days and returns to normal again completely. When the temperature rises, the child feels weak, drowsy, and may experience headache, nausea, and vomiting. When the body temperature decreases, all these symptoms disappear, but when the body temperature rises again, they may return. The cervical and submandibular lymph nodes also enlarge, as viruses multiply in them.

Depending on which organs are most affected, several forms of enterovirus infection are distinguished. Enteroviruses can affect: the central and peripheral nervous systems, the mucous membrane of the oropharynx, the mucous membrane of the eyes, skin, muscles, heart, intestinal mucosa, liver; in boys, testicular damage is possible.

When the mucous membrane of the oropharynx is affected, enteroviral tonsillitis develops. It is manifested by an increase in body temperature, general intoxication (weakness, headache, drowsiness) and the presence of a vesicular rash in the form of bubbles filled with liquid on the mucous membrane of the oropharynx and tonsils. These bubbles burst, and in their place ulcers filled with white plaque form. After recovery, no traces remain at the site of the ulcers.

When the eyes are affected, conjunctivitis develops. It can be unilateral or bilateral. Manifests itself in the form of photophobia, lacrimation, redness and swelling of the eyes. There may be hemorrhages in the conjunctiva of the eye.

When muscles are damaged, myositis develops - muscle pain. Pain appears against the background of rising temperature. Soreness is observed in the chest, arms and legs. The appearance of muscle pain, like fever, can be wave-like. As the body temperature decreases, the pain decreases or disappears completely.

When the intestinal mucosa is damaged (enteritis), loose stools are observed. The stool is of normal color (yellow or brown), liquid, without pathological (mucus, blood) impurities. The appearance of loose stools can be either against the background of an increase in temperature or isolated (without an increase in body temperature).

Enterovirus infections can affect various areas of the heart. So, when the muscle layer is damaged, myocarditis develops, when the inner layer is damaged, with the capture of the heart valves, endocarditis develops, and when the outer lining of the heart is damaged, pericarditis develops. The child may experience: increased fatigue, weakness, rapid heartbeat, drop in blood pressure, rhythm disturbances (blockades, extrasystoles), chest pain.

When the nervous system is damaged, encephalitis and meningitis can develop. The child experiences: severe headache, nausea, vomiting, increased body temperature, convulsions, paresis and paralysis, loss of consciousness.

When the liver is damaged, acute hepatitis develops. It is characterized by an enlarged liver, a feeling of heaviness in the right hypochondrium, and pain in this place. Nausea, heartburn, weakness, and increased body temperature may occur.

If the skin is damaged, an exanthema may appear - hyperemia (red coloring) of the skin, most often on the upper half of the body (head, chest, arms), does not rise above the skin level, appears simultaneously.

In boys, there may be inflammation in the testicles with the development of morchitis. Most often, this condition develops 2-3 weeks after the onset of the disease with other manifestations (sore throat, loose stools, and others). The disease goes away quite quickly and does not have any consequences, however, in rare cases, aspermia (lack of sperm) may develop in adulthood.

There are also congenital forms of enterovirus infection, when viruses enter the child’s body through the placenta from the mother. Typically, this condition has a benign course and is cured on its own, but in some cases, an enterovirus infection can cause termination of pregnancy (miscarriage) and the development of sudden death syndrome in the child (the death of the child occurs against the background of full health).

Very rarely, damage to the kidneys, pancreas, and lungs is possible. Damage to various organs and systems can be observed either isolated or combined.

Treatment of enterovirus infection

There is no specific treatment for enterovirus infection. Treatment is carried out at home, hospitalization is indicated in the presence of damage to the nervous system, heart, high temperature, which cannot be reduced for a long time with the use of antipyretics. The child is prescribed bed rest for the entire period of increased body temperature.

Meals should be light, rich in proteins. A sufficient amount of liquid is required: boiled water, mineral water without gases, compotes, juices, fruit drinks.

Treatment is carried out symptomatically depending on the manifestations of the infection - sore throat, conjunctivitis, myositis, loose stools, heart damage, encephalitis, meningitis, hepatitis, exanthema, orchitis. In some cases (sore throat, diarrhea, conjunctivitis...) prevention of bacterial complications is carried out.

Children are isolated for the entire period of illness. They can stay in the children's group after all symptoms of the disease disappear.

Prevention of enterovirus infection.

For prevention, it is necessary to observe the rules of personal hygiene: wash your hands after using the toilet, walking outside, drink only boiled water or water from a factory bottle, it is unacceptable to use water from an open source (river, lake) for a child to drink.

There is no specific vaccine against enterovirus infection, since a large number of serotypes of these viruses are present in the environment.

If your child has vomiting, diarrhea and fever

Gastrointestinal infections (gastroenteritis, inflammation of the gastric and intestinal mucosa).

More than 80% of cases. The causative agents are most often viruses (rotaviruses, caliciviruses, adenoviruses) or bacteria (some strains of E. coli - Escherichia coli, Campylobacter). Often accompanied by an increase in body temperature, but almost always by pain in the abdomen, vomiting, but not always diarrhea - vomiting in a child with fever without diarrhea, although most often the child has vomiting and diarrhea and fever. Gastroenteritis is contagious, but may not be an independent disease, but a syndrome, and accompany other bacterial infections, for example, dysentery. It is typical that such infections are accompanied by a complete loss of appetite in children, since eating any food immediately causes vomiting. Body temperature can reach high values (which is dangerous for children): typically, a child has a temperature of 38, vomiting and diarrhea. An additional danger is dehydration, which occurs within 6-8 hours with severe vomiting and diarrhea. Sources of infection can be unwashed vegetables and fruits, contaminated toys and household items, and unwashed infected hands of a child.

Food poisoning (or food intoxication).

One of the types of “food poisoning” is essentially a gastrointestinal infection (food poisoning is discussed above). But it is characteristic that even thermally processed food that does not contain infectious agents can still contain their waste products - toxins, and the risks of food poisoning do not disappear. The symptoms of such poisoning coincide with the external symptoms of the initial stage of gastroenteritis: repeated vomiting and diarrhea in a child with fever.

Dietary disorders.

The child is forced to eat more and more varied foods, not taking into account that his digestive capabilities are still limited. This can cause the child to vomit quickly and have diarrhea (diarrhea). Such food is sometimes called “heavy” or food “for adults” - smoked sausages, mushrooms, products containing flavors, dyes, flavor enhancers.

Appendicitis is acute and chronic.

The disease is of a surgical and inflammatory nature; it progresses quickly in children, and what is dangerous is that the inflammation easily spreads and passes into the abdominal cavity. It is characterized by localized pain in the right half of the abdomen or diffuse pain in the entire abdomen. The severity of symptoms such as vomiting, diarrhea and fever depend on age. So, if a child has a high temperature and a stomach ache, vomiting is observed, these are not signs of acute appendicitis. With appendicitis, the temperature is usually low-grade (37-38 degrees), vomiting is one or two times, and can be repeated up to 3 years of age. Chronic appendicitis in children is a fairly rare disease. But it is also characterized by recurring abdominal pain, nausea and fever in the child.

Pathologies of the pancreas, gall bladder, liver.

All of these diseases, in addition to specific symptoms, can be accompanied by vomiting, diarrhea and fever in the child. Viral and chronic hepatitis are often accompanied by decreased appetite, nausea, vomiting; the child may have a temperature of 38 degrees, vomiting and diarrhea. Gallstone disease (usually a hereditary disease in children) is not accompanied by a periodic increase in temperature, but the location of the stones in the “neck” of the gallbladder leads to periodic pain, nausea and periodic vomiting in the child. Cholecystitis (inflammation of the gallbladder, usually the result of infectious diseases) is often accompanied by nausea and fever in the child (low-grade, 37-38 degrees), decreased appetite, bitterness in the mouth, vomiting, and unstable stools. With pancreatitis in children (inflammation of the pancreas) in mild to moderate form, the temperature is normal or subfebrile, diarrhea and repeated vomiting may occur. But if a child has a temperature of 38, vomiting and diarrhea, this may indicate that the disease has become severe and peritonitis is possible.

Allergic reactions.

Food allergies, intolerance to certain medications, pollen allergies, allergies to animal hair, household dust, and insect bites can cause fever in children. But it is food allergies that most often cause additional symptoms at the level of the digestive tract in the form of vomiting, diarrhea and abdominal pain. For young children, an allergy to cow's milk (more precisely, to milk proteins), which should be distinguished from intolerance to milk sugar, is especially relevant. Lactose intolerance has similar symptoms such as vomiting and diarrhea in a child with a fever.

Acetone crisis (syndrome).

One of the childhood “diseases of civilization.” It is characterized by the appearance in the blood of compounds that, according to the chemical classification, have a ketone structure: acetone, aceto- and hydroxy-derivatives of acetic and butyric acids (they are products of the non-final oxidation of a group of fatty acids and the breakdown of a number of amino acids). In fact, a whole group of pathologies, which, importantly, against the background of psychological stressful situations, are provoked by improper nutritional loads, insufficient content of carbohydrate components in food, and some infectious diseases. Diarrhea and fever in a child are only the primary symptoms. Then periodic vomiting is added, the smell of acetone and its derivatives appears from the mouth, the child lacks appetite, and the temperature rises to 38 degrees. Diagnosis and treatment are extremely difficult and require careful and detailed laboratory tests. Acetone crises in the vast majority of children disappear after ten to twelve years, but consequences are possible: childhood obesity, diseases such as urolithiasis and gallstones, padagra.

Meningitis.

Viral or bacterial damage to the brain due to primary (direct infection) or secondary (pre-existing diseases - otitis media, sinusitis, chicken pox, mumps) infection. The infection enters the brain through the blood; children aged 1 to 5 years are most susceptible to the disease. Meningitis has three main symptoms: headache, fever and vomiting in the child. But in general, meningitis is diagnosed by a whole range of additional symptoms, for example, abnormal muscle behavior, as well as laboratory tests.

Poisoning with medications (or, similar, toxic substances).

Most often this is a consequence of an overdose, or uncontrolled storage of medications or dangerous toxic substances by parents. Vomiting and diarrhea in the child and fever are usually observed.

Carbon monoxide poisoning.

The possibility of poisoning a child with carbon monoxide (carbon monoxide, CO) should not be underestimated, even under normal and seemingly harmless conditions. Of course, severe and life-threatening poisoning is possible only with a high concentration of carbon monoxide, more than 800 mg/cubic meter, for example, under conditions of improper stove heating. But even in ordinary urban conditions, mild or moderate poisoning is possible with sufficiently long exposure (1-2 hours) to exhaust gases from car engines in tunnels and garages. Or if a child walks for a long time next to a busy highway, where the poisoning threshold is often exceeded. Symptoms of such poisoning, which is usually not accompanied by an increase in temperature, are headache, nausea and vomiting, general weakness, confusion in children, and impaired vision.

In what cases is this disease observed?

Pediatricians call the following manifestations of this disease:

Consumption of poor quality products. Due to the entry of pathogenic organisms into the child’s digestive tract, the functions of internal organs are disrupted, which causes lethargy, stomach colic and fever. These processes are accompanied by diarrhea.
Infection with rotavirus infection, which manifests itself in infectious diseases: measles, scarlet fever, influenza, sore throat. In such cases, the symptoms of acute respiratory disease include nausea and a gag reflex. With rotavirus infection, they make themselves felt at the initial stage.
The temperature rose. In this case, manifestations of nausea and vomiting cannot be excluded. Pediatrics considers such cases as the body’s reaction to high temperature.
Force feeding can cause nausea and vomiting.
Teething in babies. Teething can cause high fever and nausea and vomiting. Often the stress experienced by a child manifests itself in the same way.
Intestinal obstruction, pneumonia, appendicitis. With all these pathologies, the first symptoms are fever, severe headache, nausea and gag reflex.

Modern pediatrics has high-quality diagnostic equipment and effective medications. A prerequisite for successful treatment is timely consultation with a doctor. This needs to be done as quickly as possible, which will avoid serious consequences for your child. Moreover, you need to take the issue of choosing a doctor seriously. He must have an impeccable reputation.

What should parents do if their child has vomiting, diarrhea and fever?

Since such symptoms (vomiting, diarrhea, nausea with fever) are characteristic of many childhood diseases and pathologies, the most correct thing for parents in acute situations and at high temperatures would be to urgently call a doctor at home.

A doctor's consultation is required if:

vomiting and diarrhea in a child, even without fever, continues for several days;
the child has a temperature of 38, vomiting and diarrhea;
the child has a high temperature and a stomach ache;
the child tries to constantly lie down, reactions to external stimuli are impaired;
The child's stool is abnormally colored.

If the symptoms do not cause concern to parents, then at least consulting assistance from a pediatrician, pediatric gastroenterologist or other pediatric specialists is still desirable.

But even before the doctor arrives, parents can independently carry out some actions that will alleviate the child’s condition.

What not to do:

give antibiotics to the child yourself (it can only worsen the condition and disrupt the microflora of the gastrointestinal tract);
give the child enzyme preparations (especially in case of a viral infection) and other drugs “for diarrhea” yourself, or give the child a solution of potassium permanganate (diarrhea may stop for a while, but a dense and dangerous fecal plug will form);
do not use any medications at all, since they can distort the symptoms and interfere with the doctor’s ability to make a diagnosis.

What you can do (first aid):

in case of intense or periodic vomiting, help the child take the correct position (for example, on his side or in a chair leaning forward - this will protect the respiratory organs from vomit);
after vomiting and rinsing the mouth, give the child a drink to compensate for the loss of water, minerals and trace elements (you can use special saline solutions that can be purchased at pharmacy chains); if the child refuses such solutions, you can give him green tea without sugar or dried fruit compote or regular jelly; decoctions of medicinal herbs are undesirable (for example, chamomile tea leads to contractions of the stomach muscles and provokes vomiting and diarrhea);
if there is repeated urge to vomit, you can give the child some boiled water and, but only very carefully, induce vomiting by pressing on the root of the tongue to rinse the stomach of toxins;
diarrhea and vomiting in a child cause dehydration, but it worsens at high temperatures; therefore, some careful measures can be taken to bring down the temperature.

Many pathologies and infections, even with mild symptoms, cannot be cured on your own or at home. What to do if a child has vomiting, diarrhea and fever should be decided only by an experienced pediatrician, and often only in a hospital setting, since diagnosed diseases require completely different treatments.