Viral gastroenteritis in children

Case history

A 6-month-old boy presents with a history of low-grade fever of 37.7°C (100°F) and non-bilious vomiting (6 episodes per day) for 2 days. This is followed by diarrhoea (15 stools per day) 24 hours later. Stools are watery and do not contain blood or mucus. His mother is unsure of the urine output but the infant has lost 0.7 kg (1.5 lb) of weight in the past few days. His mother also reports that the infant is more irritable and has decreased activity level since the onset of the illness. The infant has never been breastfed and has not had rotavirus vaccination. He attends a daycare centre. His 2-year-old brother who attends the same daycare centre has just got over an 'upset tummy'.