Viral Gastroenteritis

SELECTED CASE An 11-month-old male infant was admitted to the Children's Hospital National Medical Center in Washington, DC, with vomiting and diarrhea. The patient was well until 3 days prior to admission when he had the onset of vomiting ("many times") that was accompanied over the next 2 days with diarrhea (with a maximum of six loose stools per day) and fever, with a maximum rectal temperature of 40.5°C. Physical examination on the day of admission showed a febrile, mildly dehydrated (=5%), irritable but not lethargic infant who had an essentially normal oropharynx, ears, lymph nodes, lungs, and abdomen. While in the hospital, the patient became afebrile the day after admission, did not vomit, but had diarrhea for the first 2 days after admission (two loose stools each day). The illness was managed by restriction of food and oral fluids for about 25 hours, when clear fluids were allowed, and