What causes diarrhea and fever in children?

Written by Yan Xin Liang
Pediatrics
Updated on March 10, 2025
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If a child has diarrhea accompanied by fever, it is generally considered to be infectious diarrhea, which includes both bacterial and viral infections. Common viral gastroenteritis is caused by rotavirus infection. Rotavirus infects the intestines, which can cause fever, vomiting, and diarrhea with frequent stooling, characterized by egg-flower or watery stools, and may also be accompanied by symptoms such as dry mouth and scanty urination. The treatment mainly focuses on fluid replenishment and symptomatic supportive care. There is also bacterial gastroenteritis, such as colitis caused by Escherichia coli infection and bacillary dysentery caused by Shigella infection, which can present with fever, diarrhea, abdominal pain, and bloody stools.

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Clinical manifestations of childhood diarrhea

Childhood diarrhea is caused by various factors that increase the frequency of bowel movements in children and also change the characteristics of the stool. The common clinical manifestations of childhood diarrhea are primarily gastrointestinal symptoms. The child may experience poor appetite, spitting up milk and vomiting, and an increased frequency of bowel movements. However, the volume of stool in mild cases is not too large, appearing thin or watery, and is yellow or yellow-green in color with a sour smell. Most cases of diarrhea without dehydration or systemic poisoning recover within a few days. In more severe cases of diarrhea, where the child experiences an increased frequency of bowel movements and the stools are watery, there can also be significant dehydration, electrolyte imbalance, and symptoms of systemic infection. These mainly manifest as either fever or lack of fever increase, irritability or lethargy and drowsiness, pale complexion, confused consciousness, and even fainting, shock symptoms.

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Pediatric viral diarrhea infections are most commonly caused by what?

Children are prone to diarrhea due to the immature development of their gastrointestinal tract, with viral infections being very common among them. The most common virus causing diarrhea in children is the rotavirus. Initially, children may show symptoms similar to a cold, followed by watery or soup-like stools. Children can easily become dehydrated and suffer from electrolyte imbalances, so it is crucial to seek medical attention promptly. Another common virus causing diarrhea in children, similar to rotavirus but often more severe, is the norovirus. Norovirus also damages the intestinal mucosa, leading to watery stools and rapid dehydration and electrolyte imbalances. Therefore, it's essential to be highly vigilant and take preventive measures against these viral infections.

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What are the symptoms of diarrhea in children?

When children experience diarrhea, it is defined by an increased frequency of bowel movements and changes in the stool's consistency, which might appear as watery, mushy, or mucus-filled. The mucus may contain blood streaks. Additionally, children may exhibit systemic symptoms including persistent fever accompanied by nausea and vomiting, while the frequency of bowel movements noticeably increases, and the fever may present as persistent high temperature. Due to frequent episodes of diarrhea, the child might show signs of dehydration such as poor skin elasticity, sunken eye sockets, and if not yet closed, a sunken fontanelle. The skin can be particularly dry, and the child may have reduced urine production. In cases of severe diarrhea, the child may also appear lethargic or drowsy and show signs of circulatory collapse.

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Why should zinc be supplemented for children with diarrhea?

Childhood diarrhea is a common gastrointestinal disease. After controlling the diarrhea in children, it is generally necessary to supplement with zinc for about ten days. During the diarrhea, the intestinal mucosa is damaged by pathogens. Zinc can promote the repair of the intestinal mucosa, while preventing the child from experiencing diarrhea again in the short term. Therefore, it is very important to supplement with zinc after childhood diarrhea. Additionally, while supplementing zinc, it is also very necessary to supplement other trace elements.

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Treatment methods for childhood diarrhea

Firstly, it is important to pay attention to the baby’s response and the condition of their urination. If the baby shows poor spirit response and less urination, it often indicates dehydration, which can be mild, moderate, or severe. Generally, mild to moderate dehydration can be treated with oral rehydration solutions, which include electrolytes replenishment. However, in cases of severe dehydration, which may suggest hypovolemic shock, emergency intravenous fluids are necessary to expand blood volume, and it is crucial to go to the hospital promptly. Additionally, oral probiotics like bifidobacteria can be administered to regulate the intestinal flora. Montmorillonite powder can also be given to protect the gastrointestinal mucosa and stop diarrhea. If bacterial infection is suspected to be the cause of diarrhea, appropriate antibiotics should be used to treat the infection, which can be administered orally or intravenously depending on the severity of the infection. Meanwhile, the baby's urination, spirit response, skin elasticity, and symptoms of dry mouth should be closely monitored to comprehensively evaluate the treatment effectiveness.