Researchers claimed to know a little about the microorganisms that infect children with isolated vomiting because they rarely submit a specimen appropriate for regular pathogen testing. Children aged 18 with suspected acute gastroenteritis who presented to two emergency departments (EDs) in Alberta, Canada, were recruited between December 2014 and August 2018. Three occurrences of vomiting and/or diarrhea in a 24-hour period, 7 days of symptoms, and a rectal swab or stool samples were required of eligible participants. Researchers calculated the percentage of children with isolated vomiting who had an enteropathogen identified and looked at clinical features, enteropathogen types, resources employed, and alternative diagnosis. At the ED visit, 295 (10.9%), 1321 (49.0%), and 1,079 (40.0%) of the 2,695 individuals, respectively, experienced solo diarrhea, vomiting, diarrhea, or isolated vomiting. The most common enteropathogen was found in those who had vomiting and diarrhea (1,067/1,321; 80.8%); detection did not differ between those who had isolated diarrhea (170/295; 57.6%) or isolated vomiting (589/1,079; 54.6%) (95% confidence interval of the difference: 3.4%, 9.3%). Children with isolated vomiting were most often infected with a virus (557/1,077; 51.7%), the most frequent of which was norovirus (321/1,077; 29.8%); 5.7% (62/1,079) were infected with a bacterial infection. In children with isolated vomiting, X-rays, ultrasounds, and urine tests were most usually used. The most common alternate etiologies were seen in individuals who had isolated vomiting (5.7%; 61/1,079). Molecular diagnostic assays and rectal swabs have a high rate of identifying enteropathogens in children with isolated vomiting. In children with isolated vomiting, molecular diagnostics is an emerging diagnostic technique.
Link:academic.oup.com/cid/article-abstract/73/8/1414/6276523?redirectedFrom=fulltext
