Review Topic
  • A 3-year-old boy is brought to the pediatric emergency department for intractable diarrhea. His symptoms initially began with him complaining of nausea and then having 2-3 episodes of emesis. His diarrhea is described as watery with no evidence of blood in the stool. The patient recently started attending daycare and has not been up to date on his vaccinations. His temperature is 102°F (38.9°C), blood pressure is 65/44 mmHg, pulse is 120/min, and respirations are 22/min. Physical examination is unremarkable. Stool studies are remarkable for rotavirus based on the enzyme-linked immunosorbent assay.
  • Classification
    • a non-enveloped, double-stranded RNA virus
      • coltivirus
        • Colorado tick fever
      • rotavirus
        • fatal diarrhea in children
Diagnostic Studies Treatment
  • Mainly transmitted by the Rocky Mountain wood tick (Dermacentor andersoni)
  • Symptoms
    • headache
    • nausea
    • vomiting
    • chills
    • myalgias
  • Physical exam
    • fever 
      • can be biphasic
        • having a fever for a few days, no fever, and then reappearing
    • petechiae or a maculopapular rash
  • Real-time polymerase chain reaction (RT-PCR)
  • Supportive treatment (e.g., managing fever)
  • Symptoms
    • vomiting
    • non-bloody and watery diarrhea
  • Physical exam
    • fever
  • Testing the stool with immune-based assays (e.g., enzyme-linked immunosorbent assay) and nucleic acid testing (PCR)
  • Supportive treatment (e.g., repleting volume loss)
  • Rotavirus vaccine as a preventative measure in all children except in patients with
    • intussusception
    • severe combined immunodeficiency

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