viral gastroenteritis
Introduction
Introduction to viral gastroenteritis Viral gastroenteritis, also known as viral diarrhea, is a group of acute intestinal infections caused by a variety of viruses. The clinical features are acute onset, nausea, vomiting, abdominal pain, diarrhea, drainage or loose stools, fever and general malaise, short course and low mortality. The clinical manifestations of gastroenteritis caused by various viruses are basically similar. There are many types of viruses associated with acute gastroenteritis, among which more important ones are rotavirus and Norwsalk-like virus. In addition, a cup-like virus (caliclvirus). Intestinal adenovirus, astrovirus, coxsackievirus, coronavirus, etc. can also cause gastroenteritis. Rotavirus gastroenteritis is the most common form of viral gastroenteritis. Ordinary rotavirus mainly invades infants and young children, and adult diarrhea rotavirus can cause outbreaks of young and middle-aged gastroenteritis. basic knowledge Probability ratio: Susceptible people: no specific people Mode of infection: digestive tract spread Complications: intussusception hemolytic uremic syndrome
Cause
Causes of viral gastroenteritis
Pathogenesis and pathological changes
Rotavirus mainly invades small intestinal villus epithelial cells, causing epithelial cells to fall off and replacing them with squamous or square epithelial cells lacking digestive enzymes. Therefore, the presence of villous enzymes such as maltase, sucrase, and lactase on the normal intestinal mucosa is reduced, resulting in absorption dysfunction. Since lactose and other disaccharides cannot be digested and absorbed, they remain in the intestine, causing changes in the osmotic pressure of the intestinal mucosa and the intestinal lumen, causing the liquid to enter the intestinal lumen and causing osmotic diarrhea.
The lesions are mainly located in the duodenum and jejunum. Epithelial cells can be square or not shaped, but most intestinal mucosal cells are still normal. There is vacuolar degeneration in the intestinal villus epithelial cells, and there are a large number of rotavirus particles in the endoplasmic reticulum.
Prevention
Viral gastroenteritis prevention
Early detection and isolation of patients; disinfection of patients' feces; attention to water and food hygiene, disinfection of tableware; baby rooms should have strict disinfection and isolation system.
Complication
Viral gastroenteritis complications Complications, intussusception, hemolytic syndrome
A small number of patients can be complicated by intussusception, rectal bleeding, hemolytic uremic syndrome, encephalitis and Reye syndrome.
Symptom
Viral gastroenteritis symptoms Common symptoms Fever accompanied by abdominal pain, ... diarrhea is watery with sticky... Mucus milk or rice soup dehydrated
(1) The incubation period of common rotavirus gastroenteritis is 1 to 3 days. The condition varies greatly. The symptoms of children aged 6-24 months are heavy, while the older children or adults are mostly mild or subclinical. The onset is urgent, and more vomiting and diarrhea, accompanied by mild to moderate fever. Diarrhea varies from ten to dozens of times a day, and the stool is mostly watery, or yellow-green loose stools, often accompanied by mild or moderate dehydration and metabolic poisoning. Some cases often have symptoms of upper respiratory tract infection before gastrointestinal symptoms appear. The disease is a self-limiting disease with a course of about 1 week. However, in a short period of time, a small number of children still have poor absorption of disaccharides, especially lactose. Diarrhea can last for several weeks, and individual cases can last for several months.
(B) adult diarrhea rotavirus gastroenteritis incubation period of 2 to 3 days, acute onset, no fever or only low fever, with diarrhea, abdominal pain, abdominal distension as the main symptoms. Diarrhea varies from 3 to 10 times a day. It is yellow water or rice soup, and there is no pus. Some cases have symptoms such as nausea and vomiting. The course of disease is 3 to 6 days, and can be as long as 10 days or more.
Examine
Examination of viral gastroenteritis
Laboratory inspection
1. Epidemiology: pay attention to the age and season of onset, the history of unclean diet before illness, and the history of contact with patients with enteritis.
2, medical history: pay attention to the onset of the disease, with or without fever, nausea, vomiting, abdominal pain, diarrhea and other symptoms, stool frequency, traits and volume; with or without cough and runny.
3. Physical examination: Pay attention to mental state, body temperature, pulse, breathing, blood pressure and degree of water loss, abdominal tenderness, and bowel sounds. Should pay attention to the presence or absence of intussusception, gastrointestinal bleeding, allergic purpura, encephalitis, pneumonia, myocarditis and so on.
4. Inspection:
(1) stool specimens: 1 stool routine; 2 enzyme-linked immunosorbent assay; 3 nucleic acid electrophoresis map analysis (PAGE), identification of rotavirus group (A, B, C), type (long, short). 4 electron microscopy or immunological methods to directly check the virus.
(2) Blood specimen: whether the double blood test rotavirus antibody is increased by more than 4 times. Patients with positive stool virus particles must be combined with clinical and serum results to be diagnosed.
Diagnosis
Diagnosis and diagnosis of viral gastroenteritis
Epidemiology
In the autumn and winter, watery diarrhea, especially in many cases, occurs at the same time, and the disease may be considered.
Clinical manifestation
Acute watery diarrhea, the symptoms of poisoning are mild, and the course of disease is self-limiting.
Differential diagnosis: The identification of the disease and cell bacteria, parasitic diarrhea is not difficult, and the identification of other viral gastroenteritis depends on specific diagnostic tests.
