Diarrhea and fever in a child
Diarrhea can be a defensive reaction by which the body tries to get rid of toxins, or provoked directly by various pathogens. Let’s take a look at the most common causes of diarrhea in children.

Diarrhea in children of the first years of life is dangerous, since repeated loose stools can lead to dehydration of the body, regardless of whether it is accompanied by fever or not. Diarrheal diseases are the second leading cause of death in children under 5 years of age. (one)

In any case, with the development of diarrhea in a child, you should consult a doctor.

Causes

Diarrhea accompanied by fever is most likely caused by an intestinal infection. By type of pathogen, intestinal infections are divided into bacterial, viral and protozoal. (2)

The most common bacterial intestinal infections include the following.

  • Dysentery is an infection caused by bacteria of the Shigella genus that infect the lining of the large intestine. The disease is characterized by repeated diarrhea with an admixture of blood, fever up to 38-39 ° C, vomiting and loss of appetite.
  • Salmonellosis is an intestinal infection caused by Salmonella. With this disease, diarrhea may be greenish in color, vomiting is observed, and the temperature rises to 38 ° C.
  • Botulism is a disease that develops when botulinum toxin, a waste product of the bacteria Clostridium botulinum, enters the body. In addition to diarrhea and vomiting with fever, the disease is characterized by damage to the nervous system with impaired visual and other functions.

Diarrhea can also be caused by viral infections – and viruses are the number one cause of acute intestinal infections in children. (3)

  • Rotavirus infection plays a leading role in this regard. “Intestinal flu” manifests itself in the form of fever up to 38-39 ° C, diarrhea, vomiting.
  • Norovirus infection in terms of the frequency of diseases competes with rotaviruses, and it develops faster. Symptoms: diarrhea, fever, fever, repeated vomiting. (four)
  • adenovirus infection. In this disease, the virus infects the intestinal mucosa, upper respiratory tract, and eyes. Against the background of elevated temperature, abdominal pain and diarrhea are added to the symptoms of a cold (sore throat, cough, runny nose).
  • Enterovirus infection also manifests itself in the form of flu-like symptoms, that is, sore throat, runny nose, cough, to which vomiting, diarrhea, and bloating are added.

Intestinal infections can also be caused by protozoa, such as giardia (giardiasis), amoebas (amebiasis), blood flukes – trematodes (schistosomiasis).

However, other reasons cannot be ruled out. Diarrhea with high fever can also occur with a number of other diseases.

  • Food poisoning with expired products (containing a large number of bacteria or their toxins – the so-called toxic infections).
  • Helminthiasis.
  • Diseases requiring surgical intervention (acute appendicitis, intestinal obstruction).
  • Other infectious diseases (measles, chickenpox, etc.).

In children under one year of age, diarrhea with fever can be caused by teething. However, this happens extremely rarely. More often, the baby’s parents observe not diarrhea, but mushy stools. Usually, after 2-3 days, the temperature drops, and a new tooth erupts in the mouth.

What to do and how to stop

In most cases, diarrhea with fever is of an infectious origin. With repeated diarrhea with a high temperature in a child, you should immediately consult a doctor.

Before the doctor arrives, the baby can be given an antipyretic, such as paracetamol or ibuprofen. Since the body loses a lot of fluid during diarrhea, which can be dangerous in children under 3 years old, the child must be given any liquid he likes (fruit drink, tea, diluted juice), chilled boiled water, and even better – glucose-salt pharmacy solutions suitable for age. You need to give liquid in small doses with breaks of 8-12 minutes. (5)

The causative agent of the infection can be determined indirectly clinically, or by doing a fecal analysis. There are two types of analysis: bakposev (it takes about 7 days) and PCR screening (it will be ready in 1-2 days, as a plus, it includes the identification of viral pathogens). Since the child needs immediate help, the doctor will prescribe treatment based on a thorough examination. The success of treatment largely depends on how quickly the measures were taken. In the classical form of diarrhea, it is enough to give the child glucose-salt solution to drink, sorbents and probiotics have a low degree of clinical effectiveness. In practice, experienced doctors use only Smecta, and Enterol as a probiotic. In the case of a bacterial infection, antibiotics may be prescribed.

Among other things, some doctors recommend giving children zinc supplements, which will also help reduce the risk of diarrhea recurring over the next three months. However, it should be borne in mind that studies on the use of zinc in cases of diarrhea are incomplete – in any case, it is worth consulting with your doctor. (6)

Dehydration is the most dangerous condition that can develop in a child with diarrhea, so watch your child carefully and if you notice any of the following signs, call an ambulance immediately:

  • the child is lethargic, he is drawn to sleep both during the day and at night. Children’s games and other activities are not easy for him;
  • after a relative improvement in the condition – a decrease in temperature and the cessation of diarrhea – vomiting suddenly begins and a repeated increase in temperature;
  • anxiety, increased irritability, or vice versa, a lowered level of consciousness, lethargy;
  • the baby refuses to eat;
  • the child drinks with greed or, on the contrary, refuses water;
  • the baby urinates less than 5 times a day, urine is dark in color;
  • the child has cracked lips and cries without tears;
  • sunken eyes;
  • The skin fold straightens out slowly. (7)

With intestinal infections, as well as within two weeks after recovery, you must follow a diet. Milk and dairy products should be excluded from the diet (can be replaced with probiotic sour-milk products, (8) but with severe diarrhea, sour milk should also be excluded, as well as other lacto-containing products), sweets, fried, smoked, fatty foods. 

It is recommended to give the child light soups, cereals (buckwheat, oatmeal, rice), boiled vegetables (carrots, broccoli), crackers, steam cutlets, baked apples, bananas, tea, compote.

Prevention

The main cause of intestinal infections is non-observance of personal hygiene rules. From an early age, a child must be taught to wash hands before eating, after going to the toilet and walking in the air.

Food products must be subjected to thorough heat treatment. Wash fresh fruits and vegetables thoroughly in running water before eating. 

Exclude fast food in dubious establishments.

You can also get vaccinated against rotavirus – consult your doctor about this.

“Unfortunately, even taking all preventive measures, it is difficult to completely exclude infection,” notes pediatrician Nikolai Komov. – It is important to understand that the main task of parents before the doctor arrives is to start rehydration, that is, abundant soldering with glucose-salt solutions. In most cases, this is sufficient. I also note that the most “dehydrating” and acute infection in childhood in our country is rotavirus infection, which is prevented by timely vaccination. The first vaccination should be done before 12 weeks of age.

Popular questions and answers

When a baby’s stomach “twists”, such unpleasant symptoms appear, many parents – especially inexperienced ones – get scared. From this, they may miss something or, on the contrary, do unnecessary actions. Pediatrician Nikolai Komov answers the most popular questions.

What is the danger of diarrhea besides dehydration?

When we talk about mild food poisoning (gastroenteritis), we can limit ourselves to soldering. In this case, the most threatening consequence will be dehydration.

But if we are talking about bacterial infections, complications can arise here. There are different groups of pathogenic Escherichia coli that can cause invasion (damage to the intestinal wall), hemolytic uremic syndrome (damaged kidney tubules) is a dangerous, almost resuscitative condition, but, fortunately, such cases are rare. In addition, there are such diseases as dysentery, typhoid fever. These diseases are dangerous for the whole organism. Fortunately, the sanitary and epidemiological service works well in Our Country, and outbreaks of the disease can be quickly localized and treated.

How long can diarrhea be treated at home? How many days to wait?

If the general condition is good and there is no vomiting, you are properly soldering the child, then it is enough to introduce a diet and observe. If diarrhea does not go away in 7-10 days (depending on the age of the child, the younger – the sooner you should see a doctor), then you need to discuss this with a pediatrician. Since, in addition to standard viral infections, bacterial infections, there are parasitic ones that can manifest themselves, including diarrhea. You need to see a doctor so that he looks at the stomach, collects an anamnesis to understand if this is a mild infection.

How to recognize diarrhea in an infant, that is, to distinguish it from the usual stool of a newborn, which can also be watery?

You need to look at the general condition and dynamics. If even before that the child had liquefied stools 4-5-10 times a day, then one can hardly speak of an infection. If before that the child walked “in a big way” once every 3-7 days (and all this is the norm for a baby, especially in the first 6 months of life), and suddenly a private liquefied stool appeared – this is most likely a symptom. In addition, any gastroenteritis is accompanied by systemic manifestations (lethargy, weakness, capriciousness and fever (not necessary). Usually, an intestinal infection begins acutely due to some kind of contact (someone else in the environment has worsened, liquefaction of the stool). If we excluded all of the above, and we see that the child feels well, and the stool is either normal or liquefied, then in general you should not worry.

Sources of

  1. Bulletin of the World Health Organization 2017. URL: https://www.who.int/news-room/fact-sheets/detail/diarhoeal-disease
  2. Babayan M.L. Modern principles of therapy for acute rotavirus infection in children // Pediatrics (Appendix to the journal Consilium Medicum). 2018; 1. S. 101-105. URL: https://cyberleninka.ru/article/n/sovremennye-printsipy-terapii-ostroy-rotavirusnoy-infektsii-u-detey/viewer
  3. Korneeva E.V. Diagnostic criteria for intestinal infections in children during the first months of life. Vestnik SUSU. 2012; No. 8. pp. 74-76. URL: https://cyberleninka.ru/article/n/diagnosticheskie-kriterii-kishechnyh-infektsiy-u-detey-pervyh-mesyatsev-zhizni/viewer
  4. Usenko D.V., Gorelova E.A. Acute intestinal infections of viral etiology in children: diagnostic and therapy options // Medical Council. 2017; No. 9. pp. 86-91. URL: https://cyberleninka.ru/article/n/ostrye-kishechnye-infektsii-virusnoy-etiologii-u-detey-vozmozhnosti-diagnostiki-i-terapii/viewer
  5. Bekhtereva M.K., Komarova A.M. How to help a child with a fever // Difficult patient. 2021. №4. Volume 19. URL: https://cyberleninka.ru/article/n/kak-mozhno-pomoch-rebenku-s-lihoradkoy/viewer
  6. Acute diarrhea in Adults and Children: A Global Perspective // ​​World Gastroenterology Organization. 2012/ Acute diarrhea in adults and children: a global perspective// Recommendations of the World Gastroenterological Organization. 2012. URL: https://www.worldgastroenterology.org/guidelines/acute-diarrhea/acute-diarrhea-english
  7. Diarrhea. Based on WHO materials // Pediatric pharmacology. 2013. №3. Volume 10 (98-107). URL: https://www.pedpharma.ru/jour/issue/viewIssue/12/8
  8. Bekhtereva M.K., Ivanova V.V., Mukhina N.V. Fermented milk products in children’s nutrition: preventive and therapeutic possibilities of use // Bulletin of Perinatology and Pediatrics. 2017; 62(2). pp. 22-29. URL: https://cyberleninka.ru/article/n/kislomolochnye-produkty-v-pitanii-detey-profilakticheskie-i-lechebnye-vozmozhnosti-ispolzovaniya/viewer
  9. Diarrhea in Children // Johns Hopkins Medicine. URL: https://www.hopkinsmedicine.org/health/conditions-and-diseases/diarrhea-in-children

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