Viral gastroenteritis in children

Case history

A 6-month-old boy presents with a history of low-grade fever of 100°F (37.7°C) and nonbilious vomiting (6 episodes per day) for 2 days. This is followed by diarrhea (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 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 center. His 2-year-old brother who attends the same daycare center has just got over a bout of "stomach flu."